The Eyes Are the Window to
Hypertension
August 10, 2004 (HealthDayNews)
The tiniest blood vessels of
the eye can provide a glimpse that may warn of future high blood pressure,
Australian
researchers report.
That finding comes from a computerized analysis of special camera images of
the retina, an experimental technique that is "not immediately applicable to
clinical practice, but has the potential to be used in the future," said Dr.
Paul Mitchell, a professor of ophthalmology at the University of Sydney and
co-author of a study on the technique in the Aug. 10 issue of Hypertension.
It is a highly advanced version of the eye examination that cardiologists
use routinely, explained study co-author Jie Jin Wang, a senior research
fellow at the university.
"Your cardiologist uses an ophthalmoscope to examine your retina, the back
of your eye, as the retinal circulation is an extension of the brain's
circulation," Wang said. "The retina is the only site in our bodies at which
vessels can be seen naked."
But that examination detects changes or damage only in the larger retinal
blood vessels, Wang said. The computer software used in the Australian
trial, which was developed at the University of Wisconsin-Madison, was able
to detect narrowing of the smallest blood vessels, called arterioles, whose
average diameter is about 200 microns. (A micron is one-millionth of a
meter.)
And a five-year
study of more than 3,600 Sydney residents showed that narrowing of
arterioles on that exquisitely small scale was a powerful harbinger of
future severe high blood pressure, the researchers report.
The study followed 1,319 participants who had normal or high normal blood
pressure. Five years later, 390 had severe high blood pressure. Narrowed
retinal arterioles predicted the development of severe high blood pressure
regardless of age, but "the association was even stronger in patients
younger than 65," the researchers reported.
It's too early to say whether such changes should prompt treatment of people
with normal blood pressure but narrowed arterioles, Mitchell said. The issue
of pre-treatment "is an interesting area for a trial," he said.
"However, we need more information about the natural history and time course
of these changes before such a trial could start," Mitchell said. "Such
information is currently being collected in our study and in the U.S.
studies that have used these techniques."
It's not known why narrowing of retinal blood vessels can predict high blood
pressure, he said. There are several theories, one of which says that there
are genetically determined reactions to even moderate narrowing of blood
vessels.
"This could be a vicious circle," Mitchell said. "In responding to low-level
elevated blood pressure, small vessels may constrict, leading to increased
blood flow resistance and further blood pressure elevation."
More information
To see the blood vessels of your retina, follow the do-it-yourself
instructions from the Exploratorium.