Retinal arteriole-to-venule ratio changes and target organ disease evolution in newly diagnosed hypertensive patients at 1-year follow-up

Coll‐de‐Tuero, Gabriel; González-Vázquez, Sonia; Rodríguez‐Poncelas, Antonio; Barceló, María Antònia; Puente, Joan Barrot-de la; Penedo, Manuel G.; Pose‐Reino, Antonio; Pena-Seijo, M; Sáez, Marc

doi:10.1016/j.jash.2013.10.002

“…63,64 Furthermore, one study of 133 patients with newly-diagnosed untreated hypertension has shown that regression of hypertensive retinopathy is concurrently associated with significantly better outcomes for left ventricular hypertrophy and other TOD. 218 This supports the concept that regression or reduction of severity of TOD is a useful intermediate endpoint for assessing the efficacy of BP-lowering medications. 44 With regards to visual outcomes, most patients with mild or moderate hypertensive retinopathy do not have visual symptoms and are not at increased risk of visual impairment.…”

Section: Management Of Hypertensive Eye Diseasesupporting

confidence: 76%

Hypertensive eye disease

Cheung

¹

,

Biousse

²

,

Keane

³

et al. 2022

Nat Rev Dis Primers

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Hypertensive eye disease includes a spectrum of pathological changes, the most wellknown being hypertensive retinopathy. Other commonly involved parts of the eye in hypertension include the choroid and optic nerve, sometimes referred to as hypertensive choroidopathy and hypertensive optic neuropathy. Together, hypertensive eye disease develops in response to acute and/or chronic elevation of blood pressure. Major advances in research over the past three decades have greatly enhanced our understanding of the epidemiology, systemic associations and clinical implications of hypertensive eye disease, particularly hypertensive retinopathy. Traditionally diagnosed via a clinical funduscopic examination, but increasingly documented on digital retinal fundus photographs, hypertensive retinopathy has long been considered a marker of systemic target organ damage (e.g., kidney disease) elsewhere in the body.Epidemiological studies indicate that hypertensive retinopathy signs are commonly seen in the general adult population, are associated with subclinical measures of vascular disease and predict risk of incident clinical cardiovascular events. New technologies, including development of non-invasive optical coherence tomography angiography, artificial intelligence (AI), and mobile ocular imaging instruments, have allowed further assessment and understanding of the ocular manifestations of hypertension and increase the potential that ocular imaging could be used for hypertension management and cardiovascular risk stratification.

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“…63,64 Furthermore, one study of 133 patients with newly-diagnosed untreated hypertension has shown that regression of hypertensive retinopathy is concurrently associated with significantly better outcomes for left ventricular hypertrophy and other TOD. 218 This supports the concept that regression or reduction of severity of TOD is a useful intermediate endpoint for assessing the efficacy of BP-lowering medications. 44 With regards to visual outcomes, most patients with mild or moderate hypertensive retinopathy do not have visual symptoms and are not at increased risk of visual impairment.…”

Section: Management Of Hypertensive Eye Diseasesupporting

confidence: 76%

Hypertensive eye disease

2022

Nat Rev Dis Primers

0

View full text Add to dashboard Cite

Hypertensive eye disease includes a spectrum of pathological changes, the most wellknown being hypertensive retinopathy. Other commonly involved parts of the eye in hypertension include the choroid and optic nerve, sometimes referred to as hypertensive choroidopathy and hypertensive optic neuropathy. Together, hypertensive eye disease develops in response to acute and/or chronic elevation of blood pressure. Major advances in research over the past three decades have greatly enhanced our understanding of the epidemiology, systemic associations and clinical implications of hypertensive eye disease, particularly hypertensive retinopathy. Traditionally diagnosed via a clinical funduscopic examination, but increasingly documented on digital retinal fundus photographs, hypertensive retinopathy has long been considered a marker of systemic target organ damage (e.g., kidney disease) elsewhere in the body.Epidemiological studies indicate that hypertensive retinopathy signs are commonly seen in the general adult population, are associated with subclinical measures of vascular disease and predict risk of incident clinical cardiovascular events. New technologies, including development of non-invasive optical coherence tomography angiography, artificial intelligence (AI), and mobile ocular imaging instruments, have allowed further assessment and understanding of the ocular manifestations of hypertension and increase the potential that ocular imaging could be used for hypertension management and cardiovascular risk stratification.

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“…AVR is currently under investigation owing to its association with an increased risk of target organ damage, especially left ventricular hypertrophy 51, 52 . It is worth noting that AVR appears to be an independent risk factor for stroke.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of microvascular and macrovascular changes in aldosteronism-related hypertension and essential hypertension

Varano

¹

,

Iacono

²

,

Tedeschi

³

et al. 2017

Sci Rep

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Case-control observational study to evaluate the microvascular and macrovascular changes in patients with hypertension secondary to primary aldosteronism (PA), essential hypertension (EH) and healthy subjects. Measurements of arterial stiffness including augmentation index (AIx) and pulse wave velocity (PWV) were assessed using a TensioClinic arteriograph system. Retinal microcirculation was imaged by a Retinal Vessel Analyzer (RVA) and a non-midriatic camera (Topcon-TRC-NV2000). IMEDOS software analyzed the retinal artery diameter (RAD), retinal vein diameters (RVD) and arteriole-to-venule ratio (AVR) of the vessels coming off the optic disc. Thirty, 39 and 35 patients were included in the PA, EH and control group, respectively. The PA group showed higher PWV values compared only with the control group. The mean brachial and aortic AIx values did not show significant difference between groups. In the PA group, the mean RVD and AVR values were significantly lower than in the EH and control groups, whereas the parameters did not differ between the EH and control groups. In conclusion, AVR appears significantly modified in the PA group compared with the EH group and could represent an early and more reliable indicator of microvascular remodeling.

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Retinal arteriole-to-venule ratio changes and target organ disease evolution in newly diagnosed hypertensive patients at 1-year follow-up

Cited by 10 publications

References 39 publications

Hypertensive eye disease

Hypertensive eye disease

Hypertensive eye disease

Comparisons of microvascular and macrovascular changes in aldosteronism-related hypertension and essential hypertension

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