Differential effects of anti-hypertensive treatment on the retinal microcirculation: an Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) sub- study
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BORIS DOI
Date of Publication
2009
Publication Type
Article
Division/Institute
Contributor
Thom, S | |
Stanton, A | |
Witt, N | |
Tapp, R | |
Chaturvedi, N | |
Mayet, J | |
Sever, P | |
Poulter, N | |
O'Brien, E | |
Hughes, A |
Series
Hypertension
ISSN or ISBN (if monograph)
0194-911X
Publisher
Lippincott Williams & Wilkins
Language
English
Publisher DOI
PubMed ID
19528363
Description
Changes in the retinal microcirculation are associated with hypertension and predict cardiovascular mortality. There are few data describing the impact of antihypertensive therapy on retinal vascular changes. This substudy of the Anglo-Scandinavian Cardiac Outcomes Trial compared the effects of an amlodipine-based regimen (373 patients) with an atenolol-based regimen (347 patients) on retinal microvascular measurements made from fundus photographs. The retinal photographs were taken at a stage in the trial when treatments were stable and blood pressure was well controlled. Amlodipine-based treatment was associated with a smaller arteriolar length:diameter ratio than atenolol-based treatment (13.32 [10.75 to 16.04] versus 14.12 [11.27 to 17.81], median [interquartile range]; P<0.01). The association remained significant after adjustment for age, sex, cholesterol, systolic and diastolic blood pressures, body mass index, smoking, and statin treatment. This effect appeared to be largely attributable to shorter retinal arteriolar segment lengths in the amlodipine-treated group and is best explained by the vasodilator effects of amlodipine causing the visible emergence of branching side vessels. Photographic assessment of the retinal vascular network may be a useful approach to evaluating microvascular structural responses in clinical trials of antihypertensive therapy.
File(s)
File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
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Thom Hypertension 2009.pdf | text | Adobe PDF | 286.04 KB | publisher | published |