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Blood pressure development and hypertensive retinopathy: 20-year follow-up of middle-aged normotensive and hypertensive men

Journal of Human Hypertension volume 24, pages 505–513 (2010)Cite this article

Abstract

Screening for hypertensive organ damage is important in assessing cardiovascular risk in hypertensive individuals. In a 20-year follow-up of normotensive and hypertensive men, signs of end-organ damage were examined, focusing on hypertensive retinopathy. In all, 56 of the original 79 men were reexamined for hypertensive organ damage, including by digital fundus photography. The diameters of the central retinal artery equivalent (CRAE) and vein were estimated and the artery-to-vein diameter ratio calculated. Components of metabolic syndrome were assessed. Fifty percent of the normotensive men developed hypertension during follow-up. Significant differences appeared in CRAE between the different blood pressure groups (P=0.025) while no differences were observed for other markers of hypertensive organ damage. There were significant relationships between CRAE and blood pressure at baseline (r=–0.466, P=0.001) and at follow-up (r=–0.508, P<0.001). A linear decrease in CRAE was observed with increasing number of components of the metabolic syndrome (β=–3.947, R2=0.105, P=0.023). Retinal vascular diameters were closely linked to blood pressures and risk factors of the metabolic syndrome. The diversity in the development of hypertensive organ damage, with changes in retinal microvasculature preceding other signs of damage, should encourage more liberal use of fundus photography in assessing cardiovascular risk in hypertensive individuals.

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Acknowledgements

We thank the technical staff at the Cardiovascular and Renal research laboratory at the Oslo University Hospital, Ullevål, Oslo for expert technical assistance. Special thanks to Ms A Skafjeld and to Ms Lise Bergengen for valuable help. This work was supported by The Norwegian Renal Association and research funding from the Department of Nephrology, Ullevål University Hospital.

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Authors and Affiliations

  1. Department of Nephrology, Ulleval University Hospital, Oslo, Norway

    H Gudmundsdottir, A Høieggen & I Os

  2. Department of Ophthalmology, Ulleval University Hospital, Oslo, Norway

    N C B B Taarnhøj

  3. Department of Cardiology, Ulleval University Hospital, Oslo, Norway

    A H Strand & S E Kjeldsen

  4. Department of Cardiovascular and Renal Research Center, Ulleval University Hospital, Oslo, Norway

    H Gudmundsdottir, A H Strand, S E Kjeldsen, A Høieggen & I Os

  5. Faculty of Medicine, University of Oslo, Oslo, Norway

    S E Kjeldsen & I Os

  6. Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark,

    N C B B Taarnhøj

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  1. H Gudmundsdottir
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Correspondence to H Gudmundsdottir.

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Gudmundsdottir, H., Taarnhøj, N., Strand, A. et al. Blood pressure development and hypertensive retinopathy: 20-year follow-up of middle-aged normotensive and hypertensive men. J Hum Hypertens 24, 505–513 (2010). https://doi.org/10.1038/jhh.2009.94

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