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This study examined whether individuals with obstructive sleep apnoea (OSA) had more retinal hypertensive microvascular disease than those with chronic obstructive pulmonary disease (COPD) and hospital controls. This was a single-centre, cross-sectional, observational study of participants recruited consecutively from a general respiratory clinic and a general medical clinic. OSA was diagnosed on overnight polysomnography study (apnoea:hypopnoea index \u2265\u20095), and controls with COPD had a forced expiratory volume\/forced vital capacity (forced expiratory ratio) &lt;\u200970%. Individuals with both OSA and COPD were excluded. Hospital controls had no COPD on respiratory function testing and no OSA on specialist physician questioning. Study participants completed a medical questionnaire, and underwent resting BP measurement, and retinal photography with a non-mydriatic camera. Images were deidentified and graded for microvascular retinopathy (Wong and Mitchell classification), and arteriole and venular calibre using a semiautomated method at a grading centre. Individuals with OSA (n\u2009=\u200979) demonstrated a trend to a higher mean arterial pressure than other hospital patients (n\u2009=\u2009143) (89.2\u2009\u00b1\u20098.9\u00a0mmHg, p\u2009=\u20090.02), and more microvascular retinopathy (p\u2009&lt;\u20090.001), and narrower retinal arterioles (134.2\u2009\u00b1\u200915.9\u00a0\u03bcm and 148.0\u2009\u00b1\u200916.2\u00a0\u03bcm respectively, p\u2009&lt;\u20090.01). Microvascular retinopathy and arteriolar narrowing were still more common in OSA than hospital controls, after adjusting for age, BMI, mean arterial pressure, smoking history and dyslipidaemia (p\u2009&lt;\u20090.01, p\u2009&lt;\u20090.01, respectively). Individuals with OSA demonstrated a trend to a higher mean arterial pressure than those with COPD (n\u2009=\u2009132, 93.2\u2009\u00b1\u200912.2\u00a0mmHg and 89.7\u2009\u00b1\u200912.8\u00a0mmHg respectively, p\u2009=\u20090.07), and more microvascular retinopathy (p\u2009=\u20090.0001) and narrower arterioles (134.2\u2009\u00b1\u200915.9 and 152.3\u2009\u00b1\u200916.8, p\u2009&lt;\u20090.01). Individuals with OSA alone had more systemic microvascular disease than those with COPD alone or other hospital patients without OSA and COPD, despite being younger in age.<\/jats:p>","DOI":"10.1038\/s41598-022-17481-9","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T16:02:34Z","timestamp":1659542554000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Obstructive sleep apnea, chronic obstructive pulmonary disease and hypertensive microvascular disease: a cross-sectional observational cohort study"],"prefix":"10.1038","volume":"12","author":[{"given":"Sky","family":"Chew","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deb","family":"Colville","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piers","family":"Canty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Hodgson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Savige","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"issue":"1","key":"17481_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1093\/sleep\/20.1.65","volume":"20","author":"DF Kripke","year":"1997","unstructured":"Kripke, D. 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