Narrow retinal vessels, high BP may be related in children
Narrow retinal arterioles were predictive of future elevated systolic BP among children, and elevated BP at baseline was predictive of microvascular impairments, researchers reported.
“From a clinical perspective it is important to realize that the retinal microvascular phenotype can predict development of high BP in young healthy children,” Henner Hanssen, MD, professor in the department of sport, exercise and health at the University of Basel, Switzerland, told Healio. “High BP and associated small vessel disease start in childhood and track into adulthood. Childhood screening programs including BP measurements and retinal vessel analysis may help counteract development of CVD later in life.”
In an analysis published in Hypertension, researchers analyzed the association between the diameter of central retinal arteriolar and venular vessels and the development of higher BP in young children (n = 391; mean age, 7 years; 46% boys). At 4 years, researchers retook measurements of the retinal vessels diameters and BP and compared them with the baseline measurements.
Investigators found that children with narrower central retinal arteriolar vessel diameter at baseline developed elevated systolic BP (beta = 0.78 mm Hg per 10 m decrease; 95% CI, 0.17-1.39; P = .012).
Moreover, children with increased systolic or diastolic BP at baseline were more likely to develop narrower central retinal arteriolar vessels at 4 years (beta = 0.154 m per 1 mm Hg systolic BP; 95% CI, 0.294 to 0.014; P = .031; and beta = 0.02 m per 1 mm Hg diastolic BP; 95% CI, 0.344 to 0.057, P = .006).
“High BP continues to be on the rise, and it is not clear how and when primary prevention strategies should be implemented,” Hanssen said in an interview. “The results of our study imply that measures need to be taken as early as childhood and relatively simple assessment of retinal vessel diameters can identify those children at risk of developing high BP and manifest CVD in adulthood.”
In other findings, both systolic BP and diastolic BP increased at 4 years (mean systolic BP increase, 3.96 mm Hg; mean diastolic BP increase, 1.73 mm Hg), whereas central retinal arteriolar vessel diameter decreased by approximately 6.32 m without significant change in the diameter of the central retinal venular equivalent (0.163 m).
“Most importantly, long term studies will have to confirm that impairments of retinal microvascular health in childhood really are predictive of CV outcomes such as MI and stroke in adulthood,” Hanssen told Healio. “We are currently looking at the association of lifestyle on BP development and retinal microvascular health in children. Physical activity and exercise may prove to be an effective primary prevention strategy for children at increased CV risk.”