Improvement in Retinal Capillary Rarefaction After Valsartan Treatment in Hypertensive Patients

J Clin Hypertens (Greenwich). 2016 Nov;18(11):1112-1118. doi: 10.1111/jch.12851. Epub 2016 Jun 16.

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / pharmacology
  • Capillaries / drug effects*
  • Capillaries / pathology
  • Double-Blind Method
  • Female
  • Humans
  • Hypertension / classification
  • Hypertension / drug therapy*
  • Male
  • Microcirculation / drug effects
  • Middle Aged
  • Retinal Vessels / drug effects
  • Retinal Vessels / pathology
  • Treatment Outcome
  • Valsartan / administration & dosage*
  • Valsartan / pharmacology

Substances

  • Antihypertensive Agents
  • Valsartan

Associated data

  • ClinicalTrials.gov/NCT00152698
  • ClinicalTrials.gov/NCT01319344