Remodeling of Retinal Small Arteries in Hypertension

• Published in: American journal of hypertension Vol. 24; no. 12; pp. 1267 - 1273
• Main Authors: Lehmann, Marina V., Schmieder, Roland E.
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.12.2011; Nature Publishing Group
• Subjects: Animals; Arterial hypertension. Arterial hypotension; Arterioles - physiopathology; Atherosclerosis - physiopathology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diagnostic Imaging - instrumentation; Diagnostic Imaging - methods; Female; Humans; Hypertension - physiopathology; Male; Medical sciences; Nitric Oxide - physiology; Rats; Retina - physiopathology; Retinal Artery - physiopathology; Retinal Diseases - diagnosis; Retinal Diseases - physiopathology; Vascular Resistance - physiology; blood pressure; wall-to-lumen ratio; lumen diameter; retinal capillary flow; hypertension; SLDF; retinal vessels; Hypertension; Cardiovascular disease; Arterial pressure; Retina; Blood pressure
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2011.166

Vascular dysfunction due to elevated blood pressure constitutes an early step in the pathogenesis of atherosclerotic disease. A better understanding of the pathophysiology and of clinical correlates of vascular remodeling in retinal arteries and arterioles offers the opportunity for a better risk stratification and treatment. In vivo vascular changes can be best detected by direct imaging techniques. In this review, we summarize the main findings of several recent studies analyzing retinal-arteriolar parameters, such as outer diameter (OD) and lumen diameter (LD), retinal capillary flow (RCF), wall-to-lumen-ratio, and wall cross-sectional area by using scanning laser Doppler flowmetry (SLDF). Blood pressure emerged as an independent determinant of the wall-to-lumen ratio (WLR) of retinal arterioles. Retinal arterioles and small arteries of hypertensive subjects showed eutrophic inward remodeling as indicated by increased WLR, decreased LD and almost unchanged wall cross-sectional area compared to normotensive subjects. These findings are in accordance with those observed in small-resistance vessels analyzed ex vivo. In hypertensive patients, an increased retinal vascular resistance has been documented and basal nitric oxide activity emerged as an independent determinant of early arteriolar remodeling. Thus, SLDF emerged as a noninvasive research tool to assess early vascular changes in the retinal circulation. American Journal of Hypertension, advance online publication 29 September 2011; doi:10.1038/ajh.2011.166