Retinal Vascular Occlusion Risks in High Blood Pressure and the Benefits of Blood Pressure Control

Abstract

center dot PURPOSE: This study aimed to evaluate the association of retinal vascular occlusion, including retinal vein oc-clusion (RVO) and retinal artery occlusion (RAO), with stages of hypertension. center dot DESIGN: Nationwide, population-based retrospective cohort study. center dot METHODS: Based on baseline blood pressure (BP) as defined by the 2017 American College of Cardiol-ogy/American Heart Association guideline, participants were categorized into 4 BP groups. For the BP change measurement, BP groups were defined based on the com-bination of baseline and follow-up BP categories. The composite retinal vascular occlusion events and hazard ratios (HRs) of retinal vascular occlusion according to BP groups were estimated. center dot RESULTS: With normal BP as the reference, multivariate-adjusted HRs for retinal vascular occlu-sion were significantly higher than in other BP groups, showing much higher HRs in stage 2 hypertension than in stage 1 (HR, 1.10 for elevated BP; 1.07 for stage 1 hypertension; and 1.32 for stage 2 hypertension). Individual disease analysis showed consistent statistical significance in RVO, whereas RAO showed nonsignif-icant results. Lowering BP significantly decreased the HRs of retinal vascular occlusion in both stage 1 and stage 2 hypertension (HR, 0.88 and 0.73, respectively). However, once hypertension was diagnosed, the risk of retinal vascular occlusion was higher compared to that in the normal BP groups. center dot CONCLUSIONS: Elevated BP, stage 1 hypertension, and stage 2 hypertension were all associated with higher reti-nal vascular occlusion risks than was normal BP. Control-ling hypertension appears to reduce the risk of subsequent retinal vascular occlusion; however, the incidence rate was still be significantly higher than that in persons who maintained a normal BP. (Am J Ophthalmol 2023;250: 111-119. (c) 2023 Elsevier Inc. All rights reserved.)