European Society of Cardiology/European Society of Hypertension versus the American College of Cardiology/American Heart Association guidelines on the cut-off values for early hypertension: a microvascular perspective.

H Shokr, D Gherghel
Author Information
  1. H Shokr: Vascular Research Laboratory, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK.
  2. D Gherghel: Vascular Research Laboratory, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK. d.gherghel@aston.ac.uk.

Abstract

The aim of this study was to investigate retinal and peripheral microvascular function in asymptomatic individuals that fall into different BP groups when using either the ESC/ESH or the ACC/AHA guidelines. Retinal and peripheral microvascular function was assessed in 358 participants by means of dynamic retinal vessel analysis and digital thermal monitoring, respectively. Blood pressure and lipid panel were also evaluated. Retinal vascular function measured in all groups belonging to the ACC/ASH classifications were within the normal values for age-matched normal population. Individuals classed as grade 1 hypertension according to the ESC/ESH guidelines, however, exhibited a significantly decreased artery baseline (p���=���0.0004) and MC (p���=���0.040), higher slope (p���=���0.0018) and decreased vein MC (p���=���0.0446) compared to age matched normal individuals. In addition, they also had significant lower artery baseline, artery BDF, MD and MC than individuals classed as stage 1 hypertension based on the ACC/ASH guidelines (p���=���0.00022, p���=���0.0179, p���=���0.0409 and p���=���0.0329 respectively). Peripheral vascular reactivity (aTR) was lower in ESC /ESH grade I compared to those graded ACC/ASH stage I hypertension (p���=���0.0122). The conclusion of this study is that microvascular dysfunctions is present at multiple levels only in individuals with ESC/ESH grade 1 hypertension. This observation could be important when deciding personalised care in individuals with early hypertensive changes.

References

  1. Lancet. 2007 Feb 3;369(9559):425-35 [PMID: 17276782]
  2. Sci Rep. 2016 Aug 31;6:32282 [PMID: 27578554]
  3. J Cardiovasc Pharmacol. 2016 Jun;67(6):451-7 [PMID: 26808712]
  4. Acta Ophthalmol. 2018 Dec;96(8):e956-e962 [PMID: 30198216]
  5. Hypertension. 2007 Oct;50(4):603-4 [PMID: 17698718]
  6. Circulation. 2005 Dec 13;112(24):3722-8 [PMID: 16330686]
  7. High Blood Press Cardiovasc Prev. 2018 Mar;25(1):35-40 [PMID: 29313304]
  8. Biomed Res Int. 2014;2014:626205 [PMID: 25003122]
  9. Heart Lung Circ. 2013 Jul;22(7):512-6 [PMID: 23608066]
  10. Circulation. 2011 Jan 18;123(2):163-9 [PMID: 21200002]
  11. Circulation. 2007 Jul 3;116(1):3-5 [PMID: 17606853]
  12. Circulation. 2006 May 16;113(19):2335-62 [PMID: 16702488]
  13. J Hum Hypertens. 2012 Jan;26(1):35-40 [PMID: 21248779]
  14. Curr Eye Res. 2009 Dec;34(12):1082-8 [PMID: 19958128]
  15. Acta Ophthalmol. 2015 Jun;93(4):e266-74 [PMID: 25487686]
  16. Graefes Arch Clin Exp Ophthalmol. 2014 Jan;252(1):23-30 [PMID: 23842712]
  17. Circulation. 2001 Aug 7;104(6):735-40 [PMID: 11489784]
  18. Microvasc Res. 2019 Nov;126:103908 [PMID: 31376402]
  19. Hypertension. 2018 Jun;71(6):e13-e115 [PMID: 29133356]
  20. Klin Monbl Augenheilkd. 2002 Jul;219(7):523-7 [PMID: 12195319]
  21. Arterioscler Thromb Vasc Biol. 2007 Jan;27(1):15-26 [PMID: 17082488]
  22. Invest Ophthalmol Vis Sci. 2004 May;45(5):1486-92 [PMID: 15111606]
  23. J Hypertens. 2018 Dec;36(12):2284-2309 [PMID: 30379783]
  24. Sci Rep. 2020 Mar 17;10(1):4881 [PMID: 32184402]
  25. Arch Intern Med. 2005 Dec 12-26;165(22):2644-50 [PMID: 16344423]
  26. J Res Med Sci. 2014 Apr;19(4):358-67 [PMID: 25097610]
  27. Acta Ophthalmol. 2016 Feb;94(1):e35-42 [PMID: 26149453]
  28. Br J Ophthalmol. 2011 Nov;95(11):1573-6 [PMID: 21362772]
  29. J Atheroscler Thromb. 2013;20(3):277-86 [PMID: 23197179]
  30. Nutr Metab Cardiovasc Dis. 2015 Mar;25(3):253-66 [PMID: 25456155]
  31. Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2341-50 [PMID: 16723443]
  32. J Hum Hypertens. 2019 Sep;33(9):635-638 [PMID: 31431680]
  33. JAMA Ophthalmol. 2013 Jan;131(1):36-43 [PMID: 22964974]
  34. Circ Cardiovasc Imaging. 2016 Dec;9(12): [PMID: 27956408]

MeSH Term

Adult
American Heart Association
Blood Pressure
Europe
Female
Humans
Hypertension
Light
Male
Microvessels
Photic Stimulation
Practice Guidelines as Topic
Retinal Vessels
Societies, Medical
United States

Word Cloud

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