EFFECTS OF ANTIHYPERTENSIVE THERAPY ON MACRO- AND MICROCIRCULATION IN ADOLESCENTS WITH ARTERIAL HYPERTENSION – A PROSPECTIVE STUDY
Bibliographic record
Abstract
Objective: Our cross-sectional study showed that arterial hypertension (AH) in children not only leads to macrovascular remodeling but also to alterations in retinal microcirculation which correlates with subclinical injury in common carotid arteries. However, no studies evaluated antihypertensive therapy's effects on microcirculation. The study aimed to prospectively evaluate hypertension-associated changes in retinal microcirculation and their correlation with hypertension-mediated organ damage (HMOD): carotid intima-media thickness (cIMT), pulse wave velocity (PWV) and left ventricular mass index (LVMi). Design and method: : 47/157 children (mean+-SD age = 14.74±3.1 years) enrolled in the cross-sectional study were observed for a mean+-SD period of 1.13±0.9 years while receiving pharmacological/non-pharmacological treatment for AH. All participants underwent ambulatory blood pressure monitoring (ABPM), HMOD assessment, and an ophthalmic examination assessing retinal vessel density (VD), foveal thickness, thickness of retinal nerve fiber layer, ganglion cell complex, and foveal avascular zone using optical coherence tomography at the start of the study and the end of follow-up. Results: At baseline, we observed a lower density of retinal vessels correlated with increased cIMT. 33/47 (70%) patients achieved normotension (24 systolic blood pressure <=95th percentile) at the end of follow-up, in whom the 24h systolic, diastolic, and mean arterial pressure (MAP) Z-scores decreased significantly by a mean of -0.70 to 0.94 Z-scores, significantly different (p<0.05) from 14 patients, in whom the BP increased/did not change during follow-up. Patients who achieved normotension significantly decreased serum cholesterol and LVMi (p<0.05) compared to patients with persistent hypertension. There were, however, no significant differences in other HMOD parameters (PWV, cIMT) and retinal VD parameters between patients achieving normotension and those with persistent hypertension. Similar results were obtained using 24h MAP or 24 diastolic blood pressure and lower BP cutoffs for normotension (90th and 75th percentiles). A trend was observed in the association between a decrease in vascular density and an increase in cIMT-SDS (p=0,088; r=-0,28). No significant correlation with microvascular parameters was found for LVMi and PWV. Conclusions: Our results show that, despite normalization of blood pressure at the end of 1 year of follow-up, there was no significant improvement in retinal microcirculation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".