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Retinal Capillary Damage Is Already Evident in Patients With Hypertension and Prediabetes and Associated With HbA1c

Dennis Kannenkeril1,2, Janis M Nolde1, Márcio Galindo Kiuchi1

  • 1Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit/Royal Perth Hospital Research Foundation, University of Western Australia, Perth, Australia.

Diabetes Care
|March 28, 2022
PubMed

Insights

Hypertension patients in the prediabetic stage show reduced retinal capillary density. This indicates early microvascular changes linked to glucose metabolism markers, even before diabetes diagnosis.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Endocrinology

Background:

  • Hypertension is a risk factor for cardiovascular and microvascular complications.
  • Prediabetes is a growing public health concern, often preceding type 2 diabetes.
  • Retinal microvasculature can reflect systemic vascular health.

Purpose of the Study:

  • To investigate changes in retinal capillary density in hypertensive patients with prediabetes.
  • To explore the association between retinal capillary density and glucose metabolism markers.

Main Methods:

  • Cross-sectional study analyzing 102 patients (62 with hypertension and normal glucose metabolism, 40 with hypertension and prediabetes).
  • Optical coherence tomography-angiography (OCT-A) used to assess foveal (CDF) and parafoveal capillary density.
  • Correlation analysis performed with HbA1c and glucose levels, and HOMA for insulin resistance (HOMA-IR).

Main Results:

  • Foveal capillary density (CDF) was significantly lower in hypertensive patients with prediabetes compared to those with normal glucose metabolism.
  • A correlation was observed between CDF and HbA1c and glucose levels across the entire cohort.
  • In patients with HbA1c <6.5%, lower CDF was associated with higher HOMA-IR (≥2.5).

Conclusions:

  • Hypertension in the prediabetic stage is associated with detectable retinal capillary changes.
  • These microvascular alterations are linked to glucose metabolism markers, including insulin resistance, even in the nondiabetic HbA1c range.
  • Retinal capillary density may serve as an early indicator of vascular damage in prediabetes.
Abstract

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