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Retinal vascular caliber and the development of hypertension: a meta-analysis of individual participant data.

TitleRetinal vascular caliber and the development of hypertension: a meta-analysis of individual participant data.
Publication TypeJournal Article
Year of Publication2014
AuthorsDing J, Wai KLay, McGeechan K, M Ikram K, Kawasaki R, Xie J, Klein R, Klein BBK, Cotch M F, Wang J J, Mitchell P, Shaw JE, Takamasa K, Sharrett ARichey
Secondary AuthorsWong TY
Corporate AuthorsMeta-Eye Study Group
JournalJ Hypertens
Volume32
Issue2
Pagination207-15
Date Published2014 Feb
ISSN1473-5598
KeywordsCohort Studies, Humans, Hypertension, Microvessels, Prospective Studies, Retinal Vessels, Risk Factors
Abstract

OBJECTIVE: Microvascular dysfunction has been suggested to be a major pathogenic factor for the development of hypertension. We examined the association between retinal vascular caliber, a marker of systemic microvascular dysfunction, and incident hypertension on a meta-analysis of individual participant data.

METHODS: We performed a systematic review with relevant studies identified through a search of electronic databases, a review of reference lists, and correspondence with experts. Studies were included if participants were selected from a general population, retinal vascular caliber was measured from photographs using computer-assisted methods at baseline, and individuals were followed up to ascertain the incidence of hypertension. Prespecified individual recorded data from six population-based prospective cohort studies were included. Discrete time proportional odds models were constructed for each study with adjustment for hypertension risk factors. Log odds ratios (ORs) per 20-μm difference were pooled using random-effects meta-analysis.

RESULTS: Among 10 229 participants without prevalent hypertension, diabetes, or cardiovascular disease, 2599 developed new-onset hypertension during median follow-up periods ranging from 2.9 to 10 years. Both narrower retinal arterioles [pooled multivariate-adjusted OR per 20-μm difference 1.29, 95% confidence interval (CI) 1.20-1.39] and wider venules (OR per 20-μm difference 1.14, 95% CI 1.06-1.23) were associated with an increased risk of hypertension. Each 20 μm narrower arterioles at baseline were associated with a 1.12 mmHg (95% CI 0.25-1.99) greater increase in SBP over 5 years.

CONCLUSIONS: Retinal arteriolar narrowing and venular widening were independently associated with an increased risk of hypertension. These findings underscore the importance of microvascular remodeling in the pathogenesis of hypertension.

DOI10.1097/HJH.0b013e32836586f4
Alternate JournalJ Hypertens
PubMed ID24322199
PubMed Central IDPMC4120649
Grant ListHHSN268201100009I / HL / NHLBI NIH HHS / United States
Z01 EY000426-05 / / Intramural NIH HHS / United States
Z99 EY999999 / / Intramural NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
ZIA EY000403-13 / / Intramural NIH HHS / United States
ZIA EY000426-10 / / Intramural NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
U10 EY006594 / EY / NEI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
ZIA EY000426-13 / / Intramural NIH HHS / United States
ZIA EY000403-14 / / Intramural NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
ZIA EY000426-08 / / Intramural NIH HHS / United States
ZIA EY000403-11 / / Intramural NIH HHS / United States
Z01 EY000426-04 / / Intramural NIH HHS / United States
ZIA EY000426-11 / / Intramural NIH HHS / United States
ZIA EY000403-10 / / Intramural NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
ZIA EY000403-09 / / Intramural NIH HHS / United States
Z01 EY000403-06 / / Intramural NIH HHS / United States
ZIA EY000403-08 / / Intramural NIH HHS / United States
Z01 EY000403-07 / / Intramural NIH HHS / United States
ZIA EY000426-09 / / Intramural NIH HHS / United States
ZIA EY000426-07 / / Intramural NIH HHS / United States
ZIA EY000426-12 / / Intramural NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
ZIA EY000426-06 / / Intramural NIH HHS / United States
ZIA EY000403-15 / / Intramural NIH HHS / United States
ZIA EY000403-12 / / Intramural NIH HHS / United States