Retinal arteriolar diameters and elevated blood pressure - The atherosclerosis risk in communities study

Narrowing and other changes in retinal arterioles may reflect damage due to hypertension, which may predict stroke and other cardiovascular diseases i ndependently of blood pressure level, Newly developed quantitative methods of assessing retinal narrowing are used to determine whether this sign is r elated only to current blood pressure or whether it also independently refl ects the effects of previous blood pressure. Retinal photography was perfor med at the third examination of Atherosclerosis Risk in Communities (ARIC) Study in 1993-1995, and results are presented for the 9,300 nondiabetic par ticipants aged 50-71 years. Generalized narrowing of smaller arterioles was strongly and monotonically related to current blood pressure in men and wo men, whether they were taking antihypertensive medications or not, and, ind ependent of current blood pressure, was consistently and monotonically rela ted to blood pressure levels measured 3 and 6 years before the retinal asse ssment. Arteriovenous nicking was also independently related to both curren t and previous blood pressures. The patterns of association suggested that these signs reflect both transient and persisting structural effects of ele vated blood pressure, in agreement with the scant pathologic literature ava ilable. The findings suggest that retinal assessment may be useful for rese arch on the microvascular contributions to clinical cardiovascular diseases .