bjective:To examine the relation b etween diameters of the retinal arterioles and 10year in cidence of hyperten-sion.Design:Population based prospective cohort study.Setting:Beaver Dam eye study.Participants:2451nor-motensive people aged 43to 84years.Main outcome measures:Diameters of retinal arte rioles and venules measured from digitised photographs of the retina taken at baseline.Measurements summarised as the arteriole:venule ratio,with a lower ratio indi cating smaller arteriolar diameters.Incident hypertension,defined as systolic blood pressure≥140mm Hg,diastolic blood pressure≥90mm Hg,or use of antihypertensive d rugs during follow up.Results:721participants developed hypertension over a 10year period.Those with lower arteriole:venule ratios had a higher cumulative incidence of hypertension(incidences of 17.4%,24.1%,31.0%,a nd 45.1%,respectively,for decreasing quarters of distribution of ar-teriole:venule ratio).After adjustment for age and sex,participants with arteriole:venul e ratios in the lowest quarter had a threefold higher risk o f hypertension(odds ratio 2.95,95%confidence interval2.77to 3.88)than those with ratios in the highest quarter.This association remained significant after further adjustment for baseline systolic and diastolic blood pressu re and other risk factors(1.82,1.39to 2.40,for lowest versus highest ratio quarters).Conclusions:Narrowed retinal arterioles are associated with long term risk of hyp ertension,suggestingthat structural alterations of the microvasculature may be linked to the development of hyperte nsion.
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