{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T05:41:08Z","timestamp":1774676468314,"version":"3.50.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare, Japan","doi-asserted-by":"publisher","award":["21AA2007"],"award-info":[{"award-number":["21AA2007"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology, Japan","doi-asserted-by":"crossref","award":["20H03907"],"award-info":[{"award-number":["20H03907"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology, Japan","doi-asserted-by":"crossref","award":["21H03159"],"award-info":[{"award-number":["21H03159"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology, Japan","doi-asserted-by":"crossref","award":["21K08123"],"award-info":[{"award-number":["21K08123"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to explore the association between the blood pressure (BP) classification defined by the 2017 American College of Cardiology (ACC)\/American Heart Association (AHA) guideline and the prevalence of retinal atherosclerosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study was a retrospective observational cross-sectional analysis using the JMDC Claims Database. We analyzed 280,599 subjects not taking any antihypertensive medications. According to the 2017 ACC\/AHA guideline, each subject was categorized as having normal BP (n = 159,524), elevated BP (n = 35,603), stage 1 hypertension (n = 54,795), or stage 2 hypertension (n = 30,677) using the BP value at the initial health checkup. Retinal photographs were assessed according to the Keith\u2013Wagener\u2013Barker system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median age was 46 years, and 50.4% subjects were men. Retinal atherosclerosis, defined as Keith\u2013Wagener\u2013Barker system grade \u22651, was observed in 3.2% in normal BP, 5.2% in elevated BP, 7.7% in stage 1 hypertension, and 18.7% in stage 2 hypertension. Compared with normal BP, elevated BP (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.23\u20131.38), stage 1 hypertension (OR, 1.71; 95% CI, 1.64\u20131.79), and stage 2 hypertension (OR, 4.10; 95% CI, 3.93\u20134.28) were associated with a higher prevalence of retinal atherosclerosis. Among 92,121 subjects without obesity, high waist circumference, diabetes mellitus, dyslipidemia, cigarette smoking, and alcohol consumption, elevated BP (OR, 1.34; 95% CI, 1.19\u20131.51), stage 1 hypertension (OR, 1.79; 95% CI, 1.61\u20131.98), and stage 2 hypertension (OR, 4.42; 95% CI, 4.00\u20134.92) were associated with a higher prevalence of retinal atherosclerosis. This association was observed in all subgroups stratified by age or sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our investigation suggests that retinal atherosclerosis could start even in individuals with elevated BP and stage 1 hypertension.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpab074","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T19:16:00Z","timestamp":1620933360000},"page":"1049-1056","source":"Crossref","is-referenced-by-count":13,"title":["Association Between Blood Pressure Classification Using the 2017 ACC\/AHA Blood Pressure Guideline and Retinal Atherosclerosis"],"prefix":"10.1093","volume":"34","author":[{"given":"Satoshi","family":"Matsuoka","sequence":"first","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan"},{"name":"The Department of 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Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Kamon","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan"},{"name":"The Department of Cardiology, New Tokyo Hospital , Matsudo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hikari","family":"Seki","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Michihata","sequence":"additional","affiliation":[{"name":"The Department of Health Services Research, The University of Tokyo , Tokyo , 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