Relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance in hypertensives


Microvascular remodeling and large artery stiffness are key determinants of cardiovascular hemodynamics and can now be studied with new non-invasive methods. Our objective was to study the relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance (total peripheral resistance (TPR)) in hypertensives. In 80 subjects (age 52±13 years; 53% males; including 23 normotensives and 57 hypertensives, among which 29 were uncontrolled hypertensives), we used: (1) the new non-invasive RTX1 adaptive optics (AO) camera (Imagine Eyes, Orsay, France) to measure the wall-to-lumen ratio (WLR) on retinal microvasculature; (2) cardiovascular magnetic resonance (CMR) imaging to assess aortic stiffness, geometry and cardiac output; and (3) the validated SphymoCor Xcel device to measure central blood pressure (BP) and carotido-femoral pulse wave velocity (Cf-PWV). TPR was calculated as the central mean BP/cardiac output ratio. WLR and TPR were significantly higher and aortic distensibility was significantly lower in hypertensives. Aortic dilation and arch elongation were found in uncontrolled hypertensives. In the univariate analysis, WLR was positively correlated with central BP (P<0.001), TPR (P<0.001) and Cf-PWV (P<0.05), and it was negatively correlated with aortic distensibility (P=0.003); however, it was not correlated with age or cardiovascular risk factors. The multivariate analysis indicated that WLR was associated with TPR (P=0.002) independent of age, BMI, gender, antihypertensive treatments, aortic diameter and central SBP. As expected, age was the major correlate of ascending aorta distensibility and Cf-PWV. New non-invasive vascular imaging methods are complementary for the detection of the deleterious effects of aging or high BP on large and small arteries. AO examination could represent a useful tool for the study and follow-up of microvasculature anatomical changes.

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ImagineEye provided technical assistance with image processing. Supported by the Institut National de la Sante' et de la Recherche Médicale (Contrat d’Interface 2011), the Agence Nationale de la Recherche (ANR-09-TECS-009 and ANR-12-TECS-0015-03), the Association Contre l’OVR (, the Cardiometabolism and Nutrition Institute ( and the Société Française d’Hypertension ( The funding organizations had no role in the design or conduct of this research. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Author contributions: DR: study conception, study realization, CMR image analysis, statistics and manuscript writing. NK: image analysis, study realization, statistics and manuscript writing. XG: study conception, study supervision, and manuscript supervision. AR: study conception, CMR acquisition and analysis and manuscript supervision. MP: study conception, OA image acquisition and manuscript supervision. EK: OA image acquisition and analysis. PC: CMR acquisition, study supervisionstudy conception, study realization, CMR image analysis, statistics and manuscript writing.

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Correspondence to David Rosenbaum.

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Rosenbaum, D., Kachenoura, N., Koch, E. et al. Relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance in hypertensives. Hypertens Res 39, 536–542 (2016).

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  • cardiovascular magnetic resonance
  • hypertension
  • microcirculation
  • optical imaging
  • remodeling

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