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C. R. Huchzermeyer, R. E. Schmieder, K. Schmid, G. Michelson; Arteriovenous Crossings Are More Sensitive Than Microalbuminuria for the Detection of Early Vascular Changes in Arterial Hypertension. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4373.
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© ARVO (1962-2015); The Authors (2016-present)
Arterial hypertension (AHT) is an important cardiovascular risk factor. The eye is the only organ where vascular changes due to AHT can be examined directly. Microalbuminuria has been introduced as a marker of vascular changes in the kidney. We compared these two markers in a working population.
226 voluntary members of the staff of the University Hospital Erlangen (mean age 47±8 years, 45 male, 181 female) underwent a thorough evaluation with extensive history, measurement of blood pressure (BP) and laboratory testing of blood and urinary samples. Fundus photographs were examined by an experienced ophthalmologist.
36 participants had a history of AHT. At the time of examination, 42 participants had an elevated systolic BP (>140 mmHg).Arteriovenous crossings were present in 17 participants. They were found in 20% of participants with elevated systolic BP at the time of examination and in 5% of the other participants (p<0.005). Elevated urinary albumine to creatinine ratios (UACR) were measured in 22 participants. 10% of participants with elevated systolic BP and 9% of those with normal systolic BP had an elevated UACR (p=0.94, not significant)Arteriovenous crossings were found in 14% of participants with a history of AHT and in 6% of the other participants (p=0.095, not significant). 11% of individuals with a history of AHT and 9% of the others had elevated UACR (p=0.08, not significant).
Arteriovenous crossings were significantly more common in participants with an elevated BP at the time of examination. There was a trend for these changes to be more common in patients with a history of AHT. On the other hand, UACR was not significantly more likely to be pathologic in patients with acutely elevated BP or with a history of AHT. It seems that funduscopic evaluation of arteriovenous crossings is more sensitive than microalbuminuria for the detection of early vascular changes caused by arterial hypertension in a relatively young population.
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