Hypertension

Effect of Intensive Blood Pressure Lowering Treatment on Retinal Microvasculature: Secondary Analysis From ESPRIT

J Am Coll CardiolPublished Secondary analysis of the ESPRIT randomised trial

Primary result · Arteriole-venule ratioResult — go to the resultβ 0.16 95% CI 0.05–0.28

Authors' conclusion

Among hypertensive patients with high cardiovascular risk, lowering systolic blood pressure with a target of <120 mm Hg compared with <140 mm Hg has a favorable impact on retinal microvasculature

Study context

Population
Adults aged ≥50 years with high CV risk, China
Participants
555 vs 526
Comparison
Intensive vs standard SBP lowering
  • Intensiven = 555
  • Standardn = 526reference
Primary endpoint
Arteriole-venule ratio (retinal arteriolar caliber)
Follow-up
3-year follow-up
Methodological detailsmulticentre, 116 sites in China, subgroup at 17 sites
  • Multicentre
  • 116 sites in China
  • Subgroup at 17 sites

Primary result

Arteriole-venule ratio

β

0.16

95% CI 0.05–0.28

P = 0.005

As reported in the abstract

Further findings

Outcomeβ (95% CI)P value
Central retinal arteriole equivalent0.14 (0.02–0.25)P = 0.02

Venular caliber

No significant results

Arteriole-venule ratio by subgroup

No heterogeneity across subgroups

Arteriolar complexity, arteriolar density, vessel tortuosity

Intensive: increased arteriolar complexity and density, reduced vessel tortuosity vs Standard

Original publication

Effect of Intensive Blood Pressure Lowering Treatment on Retinal Microvasculature: Secondary Analysis From ESPRIT. J Am Coll Cardiol. Published 17 October 2025. doi:10.1016/j.jacc.2025.05.020

Summarised from the published abstract; every number is checked against it

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