Carollo Caterina, Vadalà Maria, Ferrara Marta, Chisci Enea, La Felice Alberto, Di Natale Katia Valeria, Sorce Alessandra, Bonfiglio Vincenza Maria Elena, Mulè Giuseppe
Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Università di Palermo, 90128 Palermo, Italy.
Biomedicine, Neuroscience and Advance Diagnostic (BIND) Department, University of Palermo, 90128 Palermo, Italy.
J Pers Med. 2024 Nov 27;14(12):1123. doi: 10.3390/jpm14121123.
The complications of hypertension depend not only on the mean blood pressure (BP) but also on its variability (BPV). Recent studies suggest that the choroid may serve as an indicator of systemic vascular damage. These studies have been made possible by the increased availability of optical coherence tomography (OCT). The aim of our study was to analyze the relationship between short-term BP variability (STBPV) and choroid-retinal thickness in hypertensive patients. A total of 98 patients with a mean age of 49 ± 12 years were enrolled in the study. All participants underwent 24 h blood pressure (BP) monitoring to measure 24 h mean systolic (SBP) and diastolic blood pressure (DBP), along with their respective standard deviations (SD), the weighted SD of 24 h SBP and DBP, and the average real variability (ARV) of 24 h SBP and DBP. The choroid-retinal region was assessed using Swept-Source OCT, with choroidal thickness (ChT) and retinal thickness divided into three concentric rings, and their mean choroidal thickness (ChT-or) was calculated. The choroidal thickness of the concentric rings was found to be inversely correlated with all ARV values of the monitored blood pressure means. In particular, a correlation was observed between the ARV of daytime DBP and ChT-or. This correlation remained statistically significant (β = -0.34; = 0.02) even after adjustment for various confounding factors. The ARV of daytime DBP was the only STBPV index to maintain a significant association, in the multivariate analysis, with the central ring mean thickness (β = -0.314; = 0.001) and the inner choroidal ring mean thickness (β = -0.262; = 0.003). Our study demonstrated an independent negative association between short-term BP variability (STBPV), when expressed as ARV of daytime DBP, and choroidal thickness. This finding confirms the value of choroidal thickness as a marker of cardiovascular risk.
高血压的并发症不仅取决于平均血压（BP），还取决于其变异性（BPV）。最近的研究表明，脉络膜可能作为全身血管损伤的一个指标。光学相干断层扫描（OCT）可用性的提高使这些研究成为可能。我们研究的目的是分析高血压患者短期血压变异性（STBPV）与脉络膜 - 视网膜厚度之间的关系。共有98名平均年龄为49±12岁的患者纳入该研究。所有参与者均接受24小时血压（BP）监测，以测量24小时平均收缩压（SBP）和舒张压（DBP），以及它们各自的标准差（SD）、24小时SBP和DBP的加权SD，以及24小时SBP和DBP的平均实际变异性（ARV）。使用扫频源OCT评估脉络膜 - 视网膜区域，将脉络膜厚度（ChT）和视网膜厚度分为三个同心环，并计算其平均脉络膜厚度（ChT - or）。发现同心环的脉络膜厚度与监测血压平均值的所有ARV值呈负相关。特别是，观察到日间DBP的ARV与ChT - or之间存在相关性。即使在调整各种混杂因素后，这种相关性仍具有统计学意义（β = -0.34；P = 0.02）。在多变量分析中，日间DBP的ARV是唯一与中环平均厚度（β = -0.314；P = 0.001）和内脉络膜环平均厚度（β = -0.262；P = 0.003）保持显著关联的STBPV指标。我们的研究表明，当以日间DBP的ARV表示时，短期血压变异性（STBPV）与脉络膜厚度之间存在独立的负相关。这一发现证实了脉络膜厚度作为心血管风险标志物的价值。
