PP.04.07: [PP.04.08] DEPRESSIVE SYMPTOMS, SYMPATHETIC ACTIVITY AND RETINAL MICROVASCULAR CALIBRE IN A COHORT OF SOUTH AFRICAN MEN. (June 2015)

• Record Type: Journal Article
• Authors: Malan, N.; von Kaenel, R.; Smith, W.; Lambert, G.W.; Vilser, W.; Eikelis, N.; Reimann, M.; Cheung, C.Y.; Malan, L.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000467823.01917.3b
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Autonomic system dysfunction is associated with various changes in the retinal vasculature. Depression has recently been acknowledged as a risk factor for poor prognosis in patients with acute coronary syndrome and was associated with cardiac remodelling in Black Africans. In this study we investigated the possible association between depressive symptoms, autonomic system activity and retinal microvasculature calibre. Design and method: A total of 89 Black and 91 White men (28–68 years of age) from the follow-up phase of the Sympathetic activity and Ambulatory Blood Pressure in Africans study were included in this sub-study. Ambulatory blood pressure and depressive symptoms (PHQ-9) were obtained, while metabolic and autonomic variables were measured from fasting venous blood samples and 24-hour urine samples. Retinal vascular calibre was quantified from digital photographs using standardized protocols. Results: The Blacks had a poorer health profile than the Whites with blood pressure and glycated haemoglobin values above the cut-off for hypertension and a pre-diabetic state. They demonstrated more depressive symptoms (PHQ = 7.37, SD = 4.54), lower catecholamines and retinal arteriolar-to-venular ratio. Depressive symptoms were associated with arteriolar narrowing in the White group only. Epinephrine was positively associated with arterial narrowing and venular calibre in the Black men. Conclusions: A profile of ß-adrenergic hyporesponsivity was evident in Blacks. They revealed more depressive symptoms, a chronically challenged SNS associated with retinal vascular remodelling and possible vascular hypertrophy. Whether these changes precede or result from hyperpulsatile pressure impacting on retinal autoregulation is still debatable. A ß-adrenergic hyporesponsiveness was previously observed in this cohort emphasizing central control of the brain on the circulatory system irrespective of the vascular bed. Early ocular and mental health screening is recommended to prevent microcirculatory pathology.