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Retinal Vessel Diameters and Blood Pressure Progression in Children

Giulia Lona1, Katharina Endes1, Sabrina Köchli1

  • 1From the Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Switzerland.

Hypertension (Dallas, Tex. : 1979)
|June 30, 2020
PubMed

Insights

Rising childhood high blood pressure (BP) is linked to vascular issues. Narrower retinal arterioles predict higher BP, while elevated BP leads to microvascular changes in children, showing a two-way link.

Area of Science:

  • Pediatric Cardiology
  • Ophthalmology
  • Vascular Biology

Background:

  • Increasing global prevalence of high childhood blood pressure (BP).
  • Association between elevated BP and subclinical vascular impairments in children.
  • Lack of longitudinal data on microvascular changes predicting BP development in children.

Purpose of the Study:

  • To analyze the association between central retinal arteriolar (CRAE) and venular (CRVE) diameters and the development of higher BP over four years in school children.
  • To investigate the temporal relationship between microvascular alterations and BP changes in pediatric populations.

Main Methods:

  • Longitudinal study involving 391 children aged 6-8 years in 2014, with follow-up assessments in 262 children in 2018.
  • Standardized protocols for measuring BP and retinal vessel diameters (CRAE and CRVE) using a retinal vessel analyzer.
  • Statistical analysis to determine associations between baseline microvascular parameters and subsequent BP development, and vice versa.

Main Results:

  • Significant increases in systolic and diastolic BP observed during the 4-year follow-up.
  • A significant decrease in central retinal arteriolar equivalent (CRAE) was noted, while central retinal venular equivalent (CRVE) remained unchanged.
  • Narrower baseline CRAE predicted higher systolic BP at follow-up (P=0.012).
  • Elevated baseline systolic and diastolic BP were associated with narrower CRAE at follow-up (P=0.031 and P=0.006, respectively).

Conclusions:

  • Narrowing of retinal arterioles is a predictor for the development of elevated systolic blood pressure in children.
  • Higher initial blood pressure in children is associated with subsequent development of microvascular impairments.
  • Evidence supports a bidirectional temporal relationship between blood pressure and microvascular health in pediatric populations.

Keywords:
blood pressurecardiovascular riskchildprimary preventionretinal vessels

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