According to a new study published today in Hypertension, a journal of the American Heart Association. This is the first study to show this connection in children.
High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can occur from childhood and the prevalence of high blood pressure in children continues to increase. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk in adults. In the study “Diameter of retinal vessels and progression of blood pressure in children”, the researchers sought to predict the development of high blood pressure in children over the age of four based on measurements of blood vessels retinas.
“Hypertension remains the primary risk factor for the development of cardiovascular disease and mortality,” said Henner Hanssen, MD, lead author of the study and professor in the Department of Sport, Exercise and Health at the University of Basel in Switzerland. “Primary prevention strategies are needed to focus on testing retinal microvascular health and blood pressure in young children to identify people at increased risk for developing hypertension. The sooner we can provide treatment and implement lifestyle changes to reduce hypertension, these kids. “
Researchers examined 262 children aged six to eight in 26 schools in Basel, Switzerland, in 2014 for baseline blood pressure and retinal artery measurements. Both measurements were taken again in 2018. The initial and follow-up blood pressure measurements were taken in a sitting position after a minimum of five minutes of rest and were classified according to the guidelines of the American Academy of Pediatrics on blood pressure. These guidelines use the same measures as the 2017 American Heart Association / American College of Cardiology guidelines for the prevention, detection, assessment and management of high blood pressure in adults.
The results of the analysis indicate:
- infants with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up;
the diameter of the retinal vessels could explain 29 to 31% of the changes in the progression of systolic blood pressure between 2014 and 2018;
children with higher blood pressure at baseline developed significantly narrower arteriolar diameters at follow-up, based on weight and cardiorespiratory form; and
initial blood pressure measurements explained 66 to 69% of the change in retinal arteriolar diameter from baseline to follow-up.
“Retinal microvascular health assessments and early blood pressure monitoring can improve the classification of cardiovascular risk. Timely primary prevention strategies for children at risk for hypertension could potentially offset its burden growing in children and adults, “said Hanssen.
The researchers noted the limitations of their study, including the fact that they could not confirm blood pressure measurements over a single 24-hour period, so they would not take into account “in a lab coat” hypertension white ”, a condition in which patients have high blood pressure readings when measured in a medical setting. The stage of development, including the puberty status of each child, was not taken into account in the study, as were genetic factors or birth weight – variables that could affect the development of blood pressure and microvascular health. In addition, reference values for the appropriate diameters of retinal vessels in children do not currently exist, so future studies are needed to determine the normal age-related values during childhood.