Abstract
BackgroundTo establish the independent association between blood pressure (BP) and retinal vascular caliber, especially the retinal venular caliber, in a population of 12-year-old Chinese children.MethodsWe have examined 1501 students in the 7th grade with mean age of 12.7 years. A non-mydriatic fundus camera (Canon CR-2, Tokyo, Japan) was used to capture 450 fundus images of the right eyes. Retinal vascular caliber was measured using a computer-based program (IVAN). BP was measured using an automated sphygmomanometer (HEM-907, Omron, Kyoto, Japan).ResultsThe mean retinal arteriolar caliber was 145.3 μm (95% confidence interval [CI], 110.6–189.6 μm) and the mean venular caliber was 212.7 μm (95% CI, 170.6–271.3 μm). After controlling for age, sex, axial length, BMI, waist, spherical equivalent, birth weight, gestational age and fellow retinal vessel caliber, children in the highest quartile of BP had significantly narrower retinal arteriolar caliber than those with lower quartiles (P for trend< 0.05). Each 10-mmHg increase in BP was associated with narrowing of the retinal arterioles by 3.00 μm (multivariable-adjusted P < 0.001), and the results were consist in three BP measurements. The association between BP measures and retinal venular caliber did not persist after adjusting for fellow arteriolar caliber. And there was no significant interaction between BP and sex, age, BMI, and birth status.ConclusionsIn a large population of adolescent Chinese children, higher BP was found to be associated with narrower retinal arterioles, but not with retinal venules. Sex and other confounding factors had no effect on the relationship of BP and retinal vessel diameter.
Highlights
To establish the independent association between blood pressure (BP) and retinal vascular caliber, especially the retinal venular caliber, in a population of 12-year-old Chinese children
Children with highest quartile of BP were more likely to have narrower retinal arteriolar caliber than those in the lowest quartile after multivariable-adjustment, with a mean difference of 6–7 μm between the highest and lowest quartiles, and the results were consistent for three BP measurements
In Model 1 and Model 2, children with higher BP quartiles had consistently and significantly narrower arteriolar to venular ratio (AVR) (P < 0.001 for trend), and the results were consistent for three BP measurements
Summary
To establish the independent association between blood pressure (BP) and retinal vascular caliber, especially the retinal venular caliber, in a population of 12-year-old Chinese children. Retinal microcirculation shares the same anatomic architecture and physiological feature with other terminal organs elsewhere in the body [2]. These characteristics increase its utility as a tool to study the clinical performance of microvascular diseases. With the improvement of retinal imaging the computer-assistant analysis techniques from digital retinal images [3], plenty of epidemiological studies in adult populations have displayed that abnormal changes in retinal vascular caliber (predominantly retinal arteriolar and venular caliber) are closely associated with some systemic vascular abnormalities such as cardiovascular risk factors [4], hypertension [5], coronary heart disease [6], risk of diabetes and stroke [7], cerebral infarcts and white matter lesions [8], and renal disease [9], independent of other risk factors
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