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Meta-Analysis
. 2025 Jan 18;27(1):9.
doi: 10.1007/s11906-025-01326-7.

Does Nocturnal Blood Pressure Matter in Retinal Small Vessels? A Systematic Review and Meta-Analysis of the Literature

Christina Antza  1 , Smaro Palaska  1 , Panagiota Anyfanti  1 , Dimitris Triantis  1 , Stavros Fyntrilakis  1 , Yusuf ZiyaSener  2 , Vasilios Kotsis  3
Affiliations
Meta-Analysis

Does Nocturnal Blood Pressure Matter in Retinal Small Vessels? A Systematic Review and Meta-Analysis of the Literature

Christina Antza et al. Curr Hypertens Rep. .

Abstract

Purpose of the review: Τhe association between nocturnal blood pressure (BP) and alterations in the retinal microvasculature remains understudied, with few available studies to provide conflicting results. Therefore, we conducted a systematic review and meta-analysis to determine whether an association exists between retinal microvascular alterations and nocturnal BP patterns, determined by 24h ambulatory BP measurement.

Recent findings: Our search concluded to 1002 patients (6 studies). A total of 3 studies (411 patients) were enrolled in the meta-analysis. Central retinal arteriolar equivalent found to be not different between patients with and without dipping status (mean differences [MD]: -0.01; 95% CI: -0.23 to 0.20; I²=0%; P < 0.610). Regarding central retinal venular equivalent, dippers showed significantly lower values compared to non-dippers (MD: -0.25; 95% CI: -0.47 to -0.03; I²=0%; P < 0.024). For the comparison between nighttime and daytime BP regarding the damage in small retinal vessels, we identified only 5 studies. Due to different evaluated outcomes as well as due to the heterogeneity of outcomes and different grouping of patients based on different BP cut-off values, these results couldn't be analyzed quantitatively. In summary, this is the first effort to summarize evidence on the effects of day-to-night variation of BP on the retinal small vessels. According to the findings of the present systematic review and meta-analysis, non-dipping status may be associated with retinal venular dilatation, and elevated nighttime BP with retinal arteriolar narrowing. Further studies are warranted to elucidate the impact of nocturnal BP patterns in the retinal microvasculature.

Keywords: Dipping status; Meta-analysis; Nighttime hypertension; Nocturnal hypertension; Non-dipping status; Retinal small vessels.

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Conflict of interest statement

Compliance with Ethical Standards. Conflict of Interest: The authors declare no competing interests. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Informed Consent: This study is a meta-analysis, it is not an original study and as so, no informed consent is needed.

Figures

Fig. 1
Fig. 1
Summary of evidence search and selection
Fig. 2
Fig. 2
Forest plot of the effect of dipping versus non-dipping status on central retinal arteriolar equivalent
Fig. 3
Fig. 3
Forest Plot of the effect of dipping versus non-dipping status on central retinal venular equivalent
See this image and copyright information in PMC

References

    1. Cheung CY, Biousse V, Keane PA, Schiffrin EL, Wong TY. Hypertensive eye disease. Nat Rev Dis Primers. 2022;8(1):14. - PubMed
    1. Keith NM, Wagener HP, Barker NW. Some different types of essential hypertension: their course and prognosis. Am J Med Sci. 1974;268(6):336–45. - PubMed
    1. Kim HR, Lee NK, Lee CS, Byeon SH, Kim SS, Lee SW, et al. Retinal Vascular Occlusion Risks in High Blood Pressure and the Benefits of Blood Pressure Control. Am J Ophthalmol. 2023;250:111–9. - PubMed
    1. Iorga RE, Costin D, Munteanu-Dănulescu RS, Rezuș E, Moraru AD. Non-invasive retinal vessel analysis as a predictor for cardiovascular disease. J Pers Med. 2024;14(5):501. 10.3390/jpm14050501. - PMC - PubMed
    1. Triantafyllou A, Anyfanti P, Koletsos N, Malliora A, Lamprou S, Dipla K, et al. Clinical significance of altered vascular morphology and function in normotension. Curr Hypertens Rep. 2023;25(10):287–97. - PMC - PubMed

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