Associations between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT)

Ying Meng; Lishun Liu; Xuling Chen; Liang Zhao; Haicheng She; Wenbo Zhang; Jing Zhang; Xianhui Qin; Jianping Li; Xiping Xu; Binyan Wang; Fanfan Hou; Genfu Tang; Rongfeng Liao; Yong Huo; Jun Li; Liu Yang

doi:10.1111/jch.14820

Associations between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT)

J Clin Hypertens (Greenwich). 2024 Apr 29. doi: 10.1111/jch.14820. Online ahead of print.

Authors

Ying Meng^{1

2}, Lishun Liu³, Xuling Chen⁴, Liang Zhao¹, Haicheng She^{5

6}, Wenbo Zhang¹, Jing Zhang¹, Xianhui Qin⁷, Jianping Li⁸, Xiping Xu⁷, Binyan Wang⁹, Fanfan Hou⁷, Genfu Tang⁹, Rongfeng Liao¹⁰, Yong Huo⁸, Jun Li¹, Liu Yang¹

Affiliations

¹ Department of Ophthalmology, Peking University First Hospital, Beijing, China.
² Department of Ophthalmology, Peking University International Hospital, Beijing, China.
³ Graduate School at Shenzhen, Tsinghua University, Beijing, China.
⁴ Department of Ophthalmology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
⁵ Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
⁶ Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China.
⁷ National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁸ Department of Cardiology, Peking University First Hospital, Beijing, China.
⁹ School of Health Administration, Anhui University, Hefei, China.
¹⁰ Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

PMID: 38683601
DOI: 10.1111/jch.14820

Abstract

Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .

Keywords: Keith‐Wagener‐Barker classification; fundus photograph; hypertension; hypertensive retinopathy; pulse wave velocity.

Abstract

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