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Association Between Blood Pressure Classification Using the 2017 ACC/AHA Blood Pressure Guideline and Retinal

Satoshi Matsuoka1,2, Hidehiro Kaneko1,3, Yuichiro Yano4,5

  • 1The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.

American Journal of Hypertension
|May 19, 2021
PubMed

Insights

Elevated blood pressure (BP) and stage 1 hypertension are linked to a higher prevalence of retinal atherosclerosis, even in individuals without other risk factors. This suggests early detection and management of BP are crucial for eye health.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Public Health

Background:

  • The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline updated blood pressure (BP) classifications.
  • Retinal atherosclerosis is a potential indicator of systemic vascular health.

Purpose of the Study:

  • To investigate the association between the 2017 ACC/AHA BP classification and the prevalence of retinal atherosclerosis.
  • To determine if elevated BP categories are linked to increased retinal atherosclerosis in a large, medication-naïve population.

Main Methods:

  • Retrospective observational cross-sectional analysis of 280,599 subjects from the JMDC Claims Database.
  • Subjects classified into normal BP, elevated BP, stage 1 hypertension, or stage 2 hypertension groups based on the 2017 ACC/AHA guideline.
  • Retinal photographs assessed using the Keith-Wagener-Barker system for atherosclerosis grading.

Main Results:

  • Retinal atherosclerosis prevalence increased with BP categories: 3.2% (normal BP) to 18.7% (stage 2 hypertension).
  • Elevated BP (OR 1.30), stage 1 hypertension (OR 1.71), and stage 2 hypertension (OR 4.10) were significantly associated with higher retinal atherosclerosis prevalence compared to normal BP.
  • These associations remained significant even after excluding subjects with obesity, diabetes, dyslipidemia, and other risk factors.

Conclusions:

  • Retinal atherosclerosis may be present even in individuals with elevated BP and stage 1 hypertension.
  • The findings highlight the importance of BP management for preventing early signs of vascular damage in the retina.
Abstract

Keywords:
ACC/AHA guidelineKeith–Wagener–Barkerblood pressurehypertensionretinal atherosclerosis

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