Children: Blood pressure and Microcirculation

Blood Pressure and Retinal Arteriolar Narrowing in Children

Paul Mitchell; Ning Cheung; Kristin de Haseth; Bronwen Taylor; Elena Rochtchina; F. M. Amirul Islam; Jie Jin Wang; Seang Mei Saw; Tien Y. Wong
From the Centre for Vision Research (P.M., B.T., E.R., J.J.W.), Department of Ophthalmology, University of Sydney, New South Wales, Australia; Centre for Eye Research Australia (N.C., K.d.H., F.M.A.I., J.J.W., T.Y.W.), University of Melbourne, Victoria, Australia; Royal Melbourne Hospital (N.C.), Victoria, Australia; Medical University Leiden (K.d.H.), Leiden, The Netherlands; and Singapore Eye Research Institute (S.M.S., T.Y.W.) and the Department of Community, Occupational and Family Medicine (S.M.S.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Retinal arteriolar narrowing is a known response of hypertension and independently predicts cardiovascular mortality in adults. Whether elevated blood pressure leads to retinal arteriolar narrowing in young children is unknown.

We examined the relationship of retinal vascular caliber and blood pressure levels in 2 population-based cohorts among children aged 6 to 8 years in Sydney, Australia (1572 children) and Singapore (380 children). Participants had digital retinal photographs and measurement of retinal arteriolar (or small artery) and venular (or small vein) caliber.

Children with higher quartiles of blood pressure had significantly narrower retinal arterioles than those with lower blood pressure (retinal arteriolar caliber 162.8, 161.0, 157.8, and 157.1 µm (P for trend<0.001), trend="0.0024">

After controlling for age, sex, race, body mass index, refraction, and birth parameters, each 10-mm Hg increase in systolic blood pressure was associated with narrowing of the retinal arterioles by 2.08 µm (95% confidence interval: 1.38 to 2.79; P<0.0001) p="0.016)">

These associations were consistent across age, sex, body mass index, and birth parameters.

Retinal venules were not affected by blood pressure.

We conclude that higher childhood blood pressure is associated with retinal arteriolar narrowing.

Our data provide evidence that the effects of elevated blood pressure may manifest early in life.

Keywords: retinal arteriolar narrowing • blood pressure • children • microcirculation • hypertension

Hypertension. 2007;49:1156.

© 2007 American Heart Association, Inc.