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

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-?m 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-?m difference 1.29, 95% confidence interval (CI) 1.20-1.39] and wider venules (OR per 20-?m difference 1.14, 95% CI 1.06-1.23) were associated with an increased risk of hypertension. Each 20??m 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.

SUBMITTER: Ding J

PROVIDER: S-EPMC4120649 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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

Ding Jie J Wai Khin Lay KL McGeechan Kevin K Ikram M Kamran MK Kawasaki Ryo R Xie Jing J Klein Ronald R Klein Barbara B K BB Cotch Mary Frances MF Wang Jie Jin JJ Mitchell Paul P Shaw Jonathan E JE Takamasa Kayama K Sharrett A Richey AR Wong Tien Y TY

Journal of hypertension 20140201 2

<h4>Objective</h4>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.<h4>Methods</h4>We performed a systematic review with relevant studies identified through a search of electronic databases, a review of reference lists, and correspondence with exper ...[more]

PMID: 24322199

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Dataset Information

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

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

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