Retinal Vessel Narrowing: A Prehypertensive or Masked Hypertensive State?

Abstract

To the Editor: Based on analyses of Rotterdam Study data, Ikram et al1 concluded that retinal vessel narrowing might precede the development of systemic hypertension. The authors have made a great effort to optimize the ophthalmoscopic technique and achieved a more sensitive method than those used previously. On the other hand, baseline blood pressure measurements were rather “old-fashioned,” composed of 2 readings taken during a single visit. In an analogy to the authors’ conclusion that, compared with their methodology, “(standard ophthalmoscopy) may underestimate the extent of arteriolar narrowing and thereby the risk of hypertension,” one may suggest that, in some subjects, blood pressure at baseline was underestimated by the standard clinic measurement. Thus, …