Relationship Between Short-Term Blood Pressure Variability and Choroidal-Retinal Thicknesses Assessed by Optical
Caterina Carollo1, Maria Vadalà2, Marta Ferrara1
1Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Università di Palermo, 90128 Palermo, Italy.
Insights
Short-term blood pressure variability (BPV) is linked to reduced choroidal thickness in hypertensive patients. Specifically, average real variability of daytime diastolic blood pressure independently predicts thinner choroids, suggesting choroidal thickness as a cardiovascular risk marker.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Biology
Background:
- Hypertension complications correlate with blood pressure variability (BPV), not just mean levels.
- Choroidal changes may indicate systemic vascular damage, detectable via optical coherence tomography (OCT).
Purpose of the Study:
- To investigate the association between short-term BPV (STBPV) and choroid-retinal thickness in hypertensive individuals.
Main Methods:
- 98 hypertensive patients underwent 24-hour ambulatory blood pressure monitoring.
- Measured STBPV indices included standard deviations and average real variability (ARV).
- Choroidal and retinal thickness were assessed using Swept-Source OCT.
Main Results:
- Choroidal thickness showed an inverse correlation with all ARV values of blood pressure.
- ARV of daytime diastolic blood pressure significantly correlated with mean choroidal thickness (ChT-or).
- This association remained significant after adjusting for confounders, specifically with central and inner choroidal rings.
Conclusions:
- Short-term BPV, specifically ARV of daytime DBP, is independently and negatively associated with choroidal thickness.
- Choroidal thickness serves as a valuable indicator for assessing cardiovascular risk in hypertensive patients.
Abstract:
Background/Objectives: The complications of hypertension depend not only on the mean blood pressure (BP) but also on its variability (BPV). Recent studies suggest that the choroid may serve as an indicator of systemic vascular damage. These studies have been made possible by the increased availability of optical coherence tomography (OCT). The aim of our study was to analyze the relationship between short-term BP variability (STBPV) and choroid-retinal thickness in hypertensive patients. Methods: A total of 98 patients with a mean age of 49 ± 12 years were enrolled in the study. All participants underwent 24 h blood pressure (BP) monitoring to measure 24 h mean systolic (SBP) and diastolic blood pressure (DBP), along with their respective standard deviations (SD), the weighted SD of 24 h SBP and DBP, and the average real variability (ARV) of 24 h SBP and DBP. The choroid-retinal region was assessed using Swept-Source OCT, with choroidal thickness (ChT) and retinal thickness divided into three concentric rings, and their mean choroidal thickness (ChT-or) was calculated. Results: The choroidal thickness of the concentric rings was found to be inversely correlated with all ARV values of the monitored blood pressure means. In particular, a correlation was observed between the ARV of daytime DBP and ChT-or. This correlation remained statistically significant (β = -0.34; p = 0.02) even after adjustment for various confounding factors. The ARV of daytime DBP was the only STBPV index to maintain a significant association, in the multivariate analysis, with the central ring mean thickness (β = -0.314; p = 0.001) and the inner choroidal ring mean thickness (β = -0.262; p = 0.003). Conclusions: Our study demonstrated an independent negative association between short-term BP variability (STBPV), when expressed as ARV of daytime DBP, and choroidal thickness. This finding confirms the value of choroidal thickness as a marker of cardiovascular risk.
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