Noninvasive optical coherence tomography imaging correlates with anatomic and physiologic end-organ changes in healthy normotensives with systemic blood pressure variability

Abstract

Objective Blood pressure variability (BPV) is considered as a novel risk factor for cardiovascular disease including left ventricular hypertrophy, vascular stiffness, and renal dysfunction. In this study, we aimed to determine the relationship between ambulatory BPV with subclinical organ damage and vascular stiffness parameters in normotensive healthy subjects. Methods A total of 100 healthy subjects over 18 years of age were included in this cross-sectional study. We divided the participants into two groups according to the median value of the SD of mean 24-h blood pressure (BP) (Group 1: SD of mean 24-h BP <10.15 and Group 2: SD of mean 24-h BP >10.15). BPs of these subjects were recorded over a 24-h period using ambulatory BP monitoring. Mobil-O-Graph device was used to estimate the augmentation index (AIx), pulse wave velocity (PWV), and ambulatory BP measurement. The choroidal thickness was measured by using optical coherence tomography device. Results The mean age of the patients was 25.4 ± 5.0 years. Choroidal thickness was correlated with PWV, AIx, protein excretion, and SD of systolic and diastolic BP (P < 0.05). Additionally, participants with higher BP variability have lower choroidal thickness and higher AIx. Conclusion We showed that even in normotensive subjects, BPV correlates with choroid thickness. Thus, BPV can be an early prognostic parameter for pathologic vascular changes.

Relationship of choroidal thickness with pulsatile hemodynamics in essential hypertensive patients

“…It is noteworthy that in both these investigations important confounding factors such as renal function were not taken into account. More recently, Gök and colleagues, 9 in 116 hypertensive patients who underwent 24‐h ABPM and OCT, did not find any significant relationship of choroidal thickness with the average of BP readings recorded over 24 h. In contrast, weak correlations between BP and CTh were observed in the study of Dagel and colleagues, 10 but no multivariate analyses were performed. However, in none of these studies information about pulse pressure were provided.…”

“… 4 , 5 , 6 Controversy exists about the association of CTh with blood pressure (BP) values. 4 , 5 , 6 , 7 , 8 , 9 , 10 …”

“…However, little is known about the relationship of choroidal thickness (CTh) with peripheral and central measures of pulsatile hemodynamics. 4 , 10 …”

“…[4][5][6] Controversy exists about the association of CTh with blood pressure (BP) values. [4][5][6][7][8][9][10] The pulsatile nature of the central hemodynamics has a deleterious impact on vital organs. In a healthy cardiovascular system, the elastic properties of the large arteries ensure that pulsations in pressure and flow generated by cyclic left ventricular contraction are dampened, so that less pulsatile pressure and flow are delivered at the microvascular level.…”

“…However, little is known about the relationship of choroidal thickness (CTh) with peripheral and central measures of pulsatile hemodynamics. 4,10 The aim of our study was to assess the relationships of CTh with clinic and 24-h peripheral BP values and of CTh with estimated measures of central hemodynamics, derived from 24-h pulse wave analysis (PWA), in a group of hypertensive patients.…”