Blood Pressure Damage to Blood Vessels Detectable In Retinal Blood Vessel Thickening Interview with:
Maria Lorenza Muiesan
Department of Clinical and Experimental Sciences
University of Brescia, Internal Medicine
Brescia, Italy. What are the main findings of the study?

Dr. Muisean: An increase in the ratio of retinal arteries wall thickness to lumen diameter may serve as an in-vivo parameter of microvascular damage. We conducted a study that examined the relationship between changes in retinal arterioles wall thickness/ lumen diameter and several measures of blood pressure, including clinic brachial blood pressure,  24 hours brachial blood pressure and central aortic blood pressure. We found that the an increase of wall-to-lumen ratio of retinal arterioles was most closely related to 24 hours blood pressure.

We also confirmed previous finding of our group, showing that changes in retinal arterioles were significantly associated with an increase in aortic stiffness, an index of macrovascular damage, further supporting the concept that microvasculature and macrovasculature are strongly interrelated. Were any of the findings unexpected?

Dr. Muisean: Some previous results, obtained with measurements of clinic blood pressure and of central aortic pressure by pulse wave analysis, found a closer relationship with aortic central blood pressure.

Our findings indicate that 24 hours pressure load may be a stronger determinant of  microvasculature changes than a single measurement of aortic central pressure. What should clinicians and patients take away from your report?

Dr. Muisean: The evaluation of the arterioles in the fundus oculi by Scanner Doppler Laser Flowmetry is a noninvasive and easily repeatable procedure and shows that retinal arterioles changes are related to 24 hours blood pressure load as well as to non-invasive measures of aortic stiffness. What recommendations do you have for future research as a result of this study?

Dr. Muisean: New technologies, presently under clinical evaluation, may help in the future to noninvasively assess microvascular structural alterations and to better stratify CV  risk of hypertensive patients with consequent optimization of treatment. The wider use of a noninvasive approach for the stratification of risk in the majority of hypertensive patients may be proposed, since  microvascular structure may represent an intermediate endpoint in the evaluation of the effects of antihypertensive treatment.


Relationship of Wall-to-Lumen Ratio of Retinal Arterioles With Clinic and 24-Hour Blood Pressure , Massimo Salvetti, Claudia Agabiti Rosei, Anna Paini, Carlo Aggiusti, Anna Cancarini, Sarah Duse, Francesco Semeraro, Damiano Rizzoni, Enrico Agabiti Rosei, and Maria Lorenza Muiesan

Hypertension. 2014;HYPERTENSIONAHA.113.03004published online before print February 10 2014, doi:10.1161/HYPERTENSIONAHA.113.03004