Improvement in Retinal Capillary Rarefaction After Valsartan Treatment in Hypertensive Patients

Abstract

Decreased capillary density influences vascular resistance and perfusion. The authors aimed to investigate the influence of the renin-angiotensin receptor blocker valsartan on retinal capillary rarefaction in hypertensive patients. Retinal vascular parameters were measured noninvasively and in vivo by scanning laser Doppler flowmetry before and after 4 weeks of treatment with valsartan in 95 patients with hypertension stage 1 or 2 and compared with 55 healthy individuals. Retinal capillary rarefaction was determined with the parameters intercapillary distance (ICD) and capillary area (CapA). In hypertensive patients, ICD decreased (23.4±5.5 μm vs 21.5±5.6 μm, P<.001) and CapA increased (1564±621 vs 1776±795, P=.001) after valsartan treatment compared with baseline. Compared with healthy normotensive controls (ICD 20.2±4.2 μm, CapA 1821±652), untreated hypertensive patients showed greater ICD (P<.001) and smaller CapA (P=.019), whereas treated hypertensive patients showed no difference in ICD (P=.126) and CapA (P=.728). Therapy with valsartan for 4 weeks diminished capillary rarefaction in hypertensive patients.

Trial registration: ClinicalTrials.gov NCT00152698 NCT01319344.

© 2016 Wiley Periodicals, Inc.

Figures

Figure 1

Measurement of intercapillary distance in perfusion image with scanning laser Doppler flowmetry using an automatic full‐field perfusion image analyzer.

Figure 2

Correlation of change in 24‐hour systolic ambulatory blood pressure and intercapillary distance in hypertensive patients (r=0.276, P=.009, after adjustment for model 1: partial r=0.272, P=.017).

Figure 3

Correlation of wall‐to‐lumen ratio and capillary area in untreated hypertensive patients (r=−0.194, P=.060, after adjustment for model 1: partial r=−0.228, P=.046).