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Capillary vascular density in the retina of hypertensive patients is associated with a non-dipping pattern independent of mean ambulatory blood pressure
- Source :
- Journal of Hypertension. 39:1826-1834
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- BACKGROUND A nocturnal non-dipping pattern has been associated with hypertension-mediated organ damage (HMOD), morbidity and mortality. Retinal imaging through application of modern technologies including optical coherence tomography angiography (OCT-A) can provide detailed insights into early vascular damage. In this observational study, we investigated the relationship of microscopic vascular density in the retina measured with OCT-A and nocturnal blood pressure (BP) dipping. METHODS Retinal OCT-A and ambulatory BP monitoring (ABPM) data prospectively obtained from 142 patients referred to a tertiary hypertension clinic were analysed with regression models for associations between BP night-time dipping and retinal capillary vascular density in three different zones around the fovea. RESULTS More pronounced nocturnal SBP and DBP dipping was significantly associated with increased vascular density in the central foveal area of the retina. These associations were robust to adjustment for other available risk factors including mean daytime BP. Parafoveal and whole image vascular density did not show equivalent significant associations with nocturnal BP dipping. The results were reproducible when assessed in a subgroup of patients who had concomitant type 2 diabetes. CONCLUSION Foveal vascular density was associated with the nocturnal BP dipping pattern in hypertensive patients. These associations were robust to adjustment of relevant factors such as daytime BP. Our findings highlight the importance of nocturnal BP features reflected in ambulatory BP monitoring in the assessment of HMOD. Whether routine assessment of retinal damage markers may improve risk management of hypertensive patients remains to be determined.
- Subjects :
- medicine.medical_specialty
Ambulatory blood pressure
Physiology
Blood Pressure
Type 2 diabetes
Nocturnal
Retina
chemistry.chemical_compound
Foveal
Internal medicine
Retinal capillary
Internal Medicine
medicine
Humans
business.industry
Retinal
Blood Pressure Monitoring, Ambulatory
medicine.disease
Circadian Rhythm
medicine.anatomical_structure
Diabetes Mellitus, Type 2
chemistry
Concomitant
Hypertension
Cardiology
Cardiology and Cardiovascular Medicine
business
Microvascular Density
Subjects
Details
- ISSN :
- 14735598 and 02636352
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Journal of Hypertension
- Accession number :
- edsair.doi.dedup.....14ce479b543f26329c39d8ac3987e2d7