Retinal vessel diameters and risk of hypertension - The Rotterdam Study
Retinal vessel diameters and risk of hypertension - The Rotterdam Study
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DOI：
10.1161/01.hyp.0000199104.61945.33
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发表时间：
2006-02-01
期刊：
影响因子：
8.3
通讯作者：
de Jong, PTVM
中科院分区：
文献类型：
--
作者：
Ikram, MK;Witteman, JCM;de Jong, PTVM
全身性视网膜小动脉狭窄是全身性高血压的重要标志，较低的小动脉/小静脉直径比预示着高血压的风险。我们调查了这种关联是基于动脉或静脉直径，还是两者兼而有之。这项研究基于鹿特丹前瞻性人群研究(1990-1993)，包括1900名参与者(年龄55岁)，其中739人血压正常(收缩压和舒张压分别为120 mm和80 mm Hg)，1161人为高血压前期(收缩压120至139 mm Hg或舒张压80至89 mm Hg)。对每个参与者，在1只眼睛的数字化图像上测量视网膜小动脉和小静脉直径。经过平均6.6年的随访，808人发展为高血压，定义为收缩压=140毫米汞或舒张压=90毫米汞或使用降压药。调整了年龄、性别、随访时间、体重指数、吸烟、糖尿病、总和高密度脂蛋白胆固醇、C反应蛋白以及内膜中层厚度后，微动脉狭窄与高血压风险增加相关(每标准差的优势比：1.38；95%可信区间，1.23至1.55)；对于静脉狭窄，这一点不那么显著(优势比：1.17；95%可信区间，1.04至1.32)。小动脉/小静脉直径比每减少一次，患高血压的风险就显著增加24%。为了检验基线血压的影响，我们将受试者分成“正常血压”和“高血压前期”两组。在这些层面中，小动脉狭窄仍然与高血压有关。这些数据表明，视网膜小动脉和小静脉狭窄都可能是系统性高血压发生的先兆。
Generalized retinal arteriolar narrowing is an important sign of systemic hypertension, and a lower arteriolar: venular diameter ratio predicts the risk of hypertension. We investigated whether this association was based on arteriolar or venular diameters or both. This study was based on the prospective population - based Rotterdam Study ( 1990 - 1993) and included 1900 participants ( >= 55 years of age) of whom 739 persons had normal blood pressure ( systolic < 120 mm Hg and diastolic < 80 mm Hg) and 1161 prehypertension ( systolic 120 to 139 mm Hg or diastolic 80 to 89 mm Hg). For each participant, retinal arteriolar and venular diameters were measured on digitized images of 1 eye. After a mean follow-up of 6.6 years, 808 persons developed hypertension, defined as either systolic blood pressure >= 140 mm Hg or diastolic blood pressure >= 90 mm Hg or use of antihypertensive medication. Adjusted for age, gender, follow-up time, body mass index, smoking, diabetes mellitus, total and high-density lipoprotein cholesterol, C-reactive protein, and intima - media thickness, arteriolar narrowing was associated with an increased risk of hypertension ( odds ratio per SD: 1.38; 95% CI, 1.23 to 1.55); for venular narrowing this was less striking ( OR: 1.17; 95% CI, 1.04 to 1.32). Each SD decrease in the arteriolar: venular diameter ratio significantly increased the risk of hypertension by 24%. To examine the effect of baseline blood pressure, we stratified persons into those with "normal blood pressure" or "prehypertension." Within these strata, arteriolar narrowing was still related to incident hypertension. These data show that both retinal arteriolar and venular narrowing may precede the development of systemic hypertension.