ASSOCIATION BETWEEN CAROTID INTIMA-MEDIA THICKNESS, ATHEROSCLEROTIC PLAQUE, AND REDUCED RETINAL ARTERIOVENOUS RATIO IN HYPERTENSIVE PATIENTS

Objective: This study examines the relationship between carotid intima-media thickness (IMT), atherosclerotic plaques, and reduced retinal arteriovenous ratio (AVR) in patients with arterial hypertension. IMT is an established marker of early atherosclerosis and cardiovascular risk, while AVR, measured via non-mydriatic retinal imaging, reflects microvascular changes typical of hypertensive retinopathy. The aim is to evaluate the correlation between these parameters in hypertensive patients. Design and method: The study included 100 hypertensive patients (mean age 69.42 ± 9.2), recruited from Centro Ipertensione of the University of Milan. All patients underwent carotid ultrasound and retinal imaging. IMT >0.9 mm was considered abnormal, while atherosclerotic plaques were defined as focal thickening >1.5 mm or 50% greater than the surrounding IMT. AVR was calculated as the ratio of mean retinal arterial to venous calibers; according to Wong’s classification, an AVR <0.82 was considered reduced. Results: Patients with atherosclerosis had a significantly higher IMT (1.35 mm, 95% CI: 0.86–1.86) compared to those without (0.89 mm, 95% CI: 0.82–1.07; p = 0.001). Similarly, those with hypertensive retinopathy had an elevated IMT (1.44 mm, 95% CI: 1.34–1.87) versus those without (0.83 mm, 95% CI: 0.72–1.07; p = 0.023). AVR was significantly reduced in patients with carotid wall thickening (0.78, 95% CI: 0.75–0.81) compared to those without (0.84, 95% CI: 0.81–0.87; p = 0.031). Carotid thickening was associated with higher odds of atherosclerotic plaques (OR = 3.03, 95% CI: 1.03–8.90; p = 0.044) and hypertensive retinopathy (OR = 2.64, 95% CI: 1.02–8.90; p = 0.026).Conclusions: IMT and AVR could be considered key indicators of vascular damage in hypertension, reflecting parallel macrovascular and microvascular alterations. IMT, as a modifiable risk marker, could guide stratification and prevention strategies in hypertensive patients. This study was supported by Poliziotto Foundation, whose contribution is gratefully acknowledged.