Effects of age, blood pressure and antihypertensive treatments on retinal arterioles remodeling assessed by adaptive optics

Abstract

Remodeling reversal observed in controlled hypertensives seems to include short-term functional and long-term structural changes.

Effects of carotid baroreceptor stimulation on retinal arteriole remodeling evaluated with adaptive optics camera in resistant hypertensive patients

“…In a cohort of 45 hypertensive patients undergoing antihypertensive treatment improvement, we found a significant reduction in WLR (-6%) together with an increase of ID (+4.4%), thus confirming the reverse eutrophic remodeling after BP control in hypertensive patients [4].…”

“…Retinal arteriolar remodeling has been found to have the same characteristics of large vessel remodeling, with an increase in wall-to-lumen ratio (WLR) observed in hypertensive patients, representing an inward eutrophic remodeling. A reverse remodeling process has also been shown after the start of standard antihypertensive therapy in newly diagnosed or non-controlled non-resistant hypertensive patients [4,5]. As retinal vessels are typically devoid of adrenergic receptors and are not directly influenced by SNS, no direct effects of acute BAT-induced BP changes are expected on retinal microcirculation.…”

Assessment of retinal arteriolar morphology by noninvasive methods

“…A study in a population of normotensive study participants and hypertensive patients, performed by Meixner and Michelson [21] using adaptive optics imaging, and referenced also in the study by Rosenbaum et al [22] published in this issue of the Journal of Hypertension, highlighting the potential of the technique in assessing the age and hypertension-related remodeling of the retinal arterioles. In that study, WLR was found to be linearly related with age.…”

“…Whereas the previous study was limited in the number of study participants investigated, the new study by Rosenbaum et al [22] provides additional and more valuable clinical information obtained with this novel approach on a larger population of healthy and hypertensive study participants of all ages. These authors observed that blood pressure (BP) and age both independently increased WLR by thickening the arterial wall.…”

“…An additional result is represented by the observation of a peculiar behavior in young individuals, where hypertension seems to affect the internal diameter more than the arteriolar wall. Probably, both short-term functional and long-term structural changes contribute to remodeling reversal observed in controlled hypertensives [22].…”