Blood pressure development and hypertensive retinopathy: 20-year follow-up of middle-aged normotensive and hypertensive men

• Published in: Journal of human hypertension Vol. 24; no. 8; pp. 505 - 513
• Main Authors: Gudmundsdottir, H, Taarnhøj, N C B B, Strand, A H, Kjeldsen, S E, Høieggen, A, Os, I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2010; Nature Publishing Group
• Subjects: Adult; Analysis; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular diseases; Care and treatment; Causes of; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Complications and side effects; Diagnosis; Disease Progression; Epidemiology; Follow-Up Studies; Health Administration; Health aspects; Hematocrit; Humans; Hypertension; Hypertension - complications; Hypertension - physiopathology; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic syndrome; Microvasculature; Middle Aged; Ophthalmoscopy; original-article; Outpatients; Photography; Prevention; Public Health; Retina; Retinal Artery - pathology; Retinal diseases; Retinal Diseases - etiology; Retinal Diseases - pathology; Retinal Diseases - physiopathology; Retinopathy; Risk factors; Denmark; Norway; metabolic syndrome; blood pressure; hypertensive retinopathy; Human; Hypertension; Eye disease; Retinopathy; Cardiovascular disease; Arterial pressure; Blood pressure
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2009.94

Screening for hypertensive organ damage is important in assessing cardiovascular risk in hypertensive individuals. In a 20-year follow-up of normotensive and hypertensive men, signs of end-organ damage were examined, focusing on hypertensive retinopathy. In all, 56 of the original 79 men were reexamined for hypertensive organ damage, including by digital fundus photography. The diameters of the central retinal artery equivalent (CRAE) and vein were estimated and the artery-to-vein diameter ratio calculated. Components of metabolic syndrome were assessed. Fifty percent of the normotensive men developed hypertension during follow-up. Significant differences appeared in CRAE between the different blood pressure groups ( P =0.025) while no differences were observed for other markers of hypertensive organ damage. There were significant relationships between CRAE and blood pressure at baseline ( r =–0.466, P =0.001) and at follow-up ( r =–0.508, P <0.001). A linear decrease in CRAE was observed with increasing number of components of the metabolic syndrome (β=–3.947, R 2 =0.105, P =0.023). Retinal vascular diameters were closely linked to blood pressures and risk factors of the metabolic syndrome. The diversity in the development of hypertensive organ damage, with changes in retinal microvasculature preceding other signs of damage, should encourage more liberal use of fundus photography in assessing cardiovascular risk in hypertensive individuals.