Conventional and Ambulatory Blood Pressure as Predictors of Retinal Arteriolar Narrowing

Fang-Fei Wei, Zhen-Yu Zhang, Lutgarde Thijs, Wen-Yi Yang, Lotte Jacobs, Nicholas Cauwenberghs, Yu-Mei Gu, Tatiana Kuznetsova, Karel Allegaert, Peter Verhamme, Yan Li, H. Struyker Boudier, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Web of Science)

Abstract

At variance with the long established paradigm that retinal arteriolar narrowing trails hypertension, several longitudinal studies, all based on conventional blood pressure (CBP) measurement, proposed that retinal arteriolar narrowing indicates heightened microvascular resistance and precedes hypertension. In 783 randomly recruited Flemish (mean age, 38.2 years; 51.3% women), we investigated to what extent CBP and daytime (10 am to 8 pm) ambulatory blood pressure (ABP) measured at baseline (1989-2008) predicted the central retinal arteriolar equivalent (CRAE) in retinal photographs obtained at follow-up (2008-2015). Systolic/diastolic hypertension thresholds were 140/90 mm Hg for CBP and 135/85 mm Hg for ABP. In multivariable-adjusted models including both baseline CBP and ABP, CRAE after 10.3 years (median) of follow-up was unrelated to CBP (P >= 0.14), whereas ABP predicted CRAE narrowing (P = 0.31) between true normotension (normal CBP and ABP; prevalence, 77.6%) and white-coat hypertension (elevated CBP and normal ABP, 5.4%) and between masked hypertension (normal CBP and elevated ABP, 10.2%) and hypertension (elevated CBP and ABP, 6.8%). In conclusion, the paradigm that retinal arteriolar narrowing precedes hypertension can be explained by the limitations of CBP measurement, including nonidentification of masked and white-coat hypertension.
Original languageEnglish
Pages (from-to)511-520
JournalHypertension
Volume68
Issue number2
DOIs
Publication statusPublished - Aug 2016

Keywords

  • ambulatory blood pressure monitoring
  • blood pressure
  • hypertension
  • microcirculation
  • population science
  • retina

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