The Use of Retinal Microvascular Function and Telomere Length in Age and Blood Pressure Prediction in Individuals with Low Cardiovascular Risk

Abstract

Ageing represents a major risk factor for many pathologies that limit human lifespan, including cardiovascular diseases. Biological ageing is a good biomarker to assess early individual risk for CVD. However, finding good measurements of biological ageing is an ongoing quest. This study aims to assess the use retinal microvascular function, separate or in combination with telomere length, as a predictor for age and systemic blood pressure in individuals with low cardiovascular risk. In all, 123 healthy participants with low cardiovascular risk were recruited and divided into three groups: group 1 (less than 30 years old), group 2 (31–50 years old) and group 3 (over 50 years old). Relative telomere length (RTL), parameters of retinal microvascular function, CVD circulatory markers and blood pressure (BP) were measured in all individuals. Symbolic regression- analysis was used to infer chronological age and systemic BP measurements using either RTL or a combination of RTL and parameters for retinal microvascular function. RTL decreased significantly with age (p = 0.010). There were also age-related differences between the study groups in retinal arterial time to maximum dilation (p = 0.005), maximum constriction (p = 0.007) and maximum constriction percentage (p = 0.010). In the youngest participants, the error between predicted versus actual values for the chronological age were smallest in the case of using both retinal vascular functions only (p = 0.039) or the combination of this parameter with RTL (p = 0.0045). Systolic BP was better predicted by RTL also only in younger individuals (p = 0.043). The assessment of retinal arterial vascular function is a better predictor than RTL for non-modifiable variables such as age, and only in younger individuals. In the same age group, RTL is better than microvascular function when inferring modifiable risk factors for CVDs. In older individuals, the accumulation of physiological and structural biological changes makes such predictions unreliable.

The Effect of Bariatric Surgery on Microvascular Structure and Function, Peripheral Pressure Waveform and General Cardiovascular Risk: A Longitudinal Study

“…In agreement with previous studies, our results show that, in addition to an overall positive effect on the general risk for CVDs, bariatric surgery had also showed an improvement of the retinal arteries diameter [43,44]. Indeed, narrowing of the retinal arteries represents a well-known marker for chronic damage due to elevated BP [45][46][47][48][49] and large observational studies have already established a strong association between abnormal AVR and risk for CVD [50,51]. As such, by showing an improvement in the retinal arteries diameter, we have demonstrated a positive effect of this procedure on the general CVD risk.…”

Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

“…Their results showed a better correlation between retinal vascular function, telomere length and chronological age in individuals under 30 years of age. Systolic blood pressure was better predicted by telomere measurements [60].…”

Retinal Microvascular Abnormalities and Systemic Arterial Stiffness Are the First Manifestation of Cardiovascular Abnormalities in Patients with Untreated Moderate to Severe Obstructive Sleep Apnoea and with Low to Intermediate Cardiovascular Risk—A Pilot Study

“…The intermittent hypoxic events, associated with OSA, are known to induce an increase in the free radical production [ 30 , 31 ] which, in turn, is associated with impaired NO bioavailability and, therefore, vascular dysfunction [ 32 , 33 , 34 ]. At the retinal level, although alterations in the metabolic demand and neurovascular coupling are most largely involved in the retinal vascular response to flickering light [ 35 ], a compromised NO homoeostasis is also known to play a role in any vascular dysfunction recorded at this level.…”