Correlation Between Blood Pressure Variability And Hypertensive Retinopathy

Objective:Blood pressure variability(BPV)is associated with hypertension mediated target organ damage(HMOD).Modern techniques such as optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)for retinal imaging can predict early vascular injury.The purpose of this study is to explore the correlation between the level of BPV in hypertensive patients,including average real variability(ARV),standard deviation(SD),and coefficient of variation(CV),and the use of OCT and OCTA to measure retinal microvascular injury.Methods:After screening by the inclusion criteria,a total of 140 hypertensive patients were included in the study as the experimental group,and 70 healthy subjects as the control group.The experimental group was divided into two groups based on the median of average real variability(ARV),with 70 patients in the low ARV group and 70 patients in the high ARV group.All subjects included in the study were subjected to 24-hour ambulatory blood pressure monitoring,binocular fundus photography,OCT,and OCTA examinations to determine the average thickness of the nerve fiber layer(RNFL),the internal limiting membrane retinal pigment epithelial cell layer(ILM-RPE),the average volume thickness,vascular density(VD),and perfusion density(PD),All right eye data were selected for statistical analysis.The research data were statistically analyzed using SPSS26.0 software,and the difference was statistically significant(P<0.05).Results:1.The average RNFL thickness,average ILM-RPE volume thickness,VD and PD in the high ARV group were significantly lower than those in the low ARV group and the control group(both p<0.05).2.Systolic ARV was negatively correlated with RNFL,ILM-RPE,VD and PD.3.Multiple linear regression analysis showed that the course of disease,age,standard deviation of 24 h diastolic blood pressure and smoking history were the influencing factors of RNFL mean thickness(Adjust R2=0.558,p<0.05);The course of disease,ARV of systolic blood pressure and coefficient of variation of nocturnal systolic blood pressure were the influencing factors of ILM-RPE(Adjust R2=0.370,p<0.05);The course of disease,systolic blood pressure ARV,24-hour systolic blood pressure,best corrected visual acuity,intraocular pressure and K-W-B grade were the influencing factors of VD(Adjust R2=0.512,p<0.05);The course of disease,ARV of systolic blood pressure,diurnal systolic blood pressure,IOP,standard deviation of 24 h diastolic blood pressure,K-W-B grade and standard deviation of diurnal systolic blood pressure were the influencing factors of PD(Adjust R2=0.620,p<0.05).Conclusion:1.there is a correlation between BPV and hypertensive retinopathy,and the degree of retinopathy is more severe in hypertensive patients with greater ARV.2.HMOD progression can be monitored clinically by assessing BPV and the degree of retinopathy in hypertensive patients,and correction of BPV may be beneficial in treating or delaying the progression of HMOD.