The purpose of this study is to evaluate “nail bed capillary examination” for the control of hypertension and arteriosclerosis.
The morphologic findings of the capillaries were investigated in these diseases and correlated with their blood pressure levels and ocular fundus camera findings.
Subjects and method:
The subjects were 623 cases, from 40 to 90 years, in Asahi Town, Aichi prefecture, and 401 high school students, from 16 to 17 years. in Nagoya city Japan.
The subjects in the town were thoroughly checked up on their cerebro-and cardio-cvasular function, and students had the blood pressure measurement and physical examinations.
Nail bed capillaries and micrometer were photographed through microscope with magnification of 40× and 60×, and the enlarged prints were made for measurement and classification.
Average A/V ratio, average ratio of the width of the arterial limb to the venous limb, were calculated in each picture. All the pictures were classified into one of the ten types bases on their dominant pattern which exceeded 50 per cent in the field, but some pictures which contain several patterns in a field without predominance were classified as o-type. On the other hand, the frequencies of the person with the specific rare patterns were calculated.
Ocular fundus findings were classified according to Keith-Wagener's classification system.
Results:
The straight hairpin-like shape of the capillary pattern was the most frequent in the students and the residents under 50 years, but it became significantly less frequent with advancing age.
The frequency of the twisted capillary pattern was very low in the students, but in the residents over 40 years it became significantly high with advancing age.
The capillary pattern which showed marked bendings without twist or torsion was found more frequently in the students than in the residents over 40 years.
The pictures with various kinds of capillary patterns were more frequently seen in the residents over 40 years than in the students and significantly increased with advancing age.
In the students, the pictures with various kinds of capillary patterns. A/V ratio of 1/2 or less and appearance of subpapillary plexus were significantly more frequent in the hypertensives than in the normotensives. In the residents over 40 years, the pictures which had the dominant pattern with twist or torsion, A/V ratio of 2/3 or less and appearance of sub-papillary plexus were significantly more frequent in the hypertensives than in the normotensives.
Normal ocular fundus findings were frequent in the subjects with the dominant pattern of straight hairpin-like shape. Ocular fundus abnormalities were frequent in the subjects whose pictures had the dominant pattern with transformations, especially with twist or torsion and Grade II or more advanced changes were also highly frequent in this group. In the subjects with ocular fundus abnormality, A/V ratio of 2/3 or less and recognition of sub-papillary plexus were also more frequent, and there was a tendency that A/V ratio of nail bed capillary became smaller with advance of ocular fundus abnormality.
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