Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs. Issue 4 (1st December 2016)

• Record Type: Journal Article
• Authors: Chiang, Lap-kin; Yau, Michael K.C.; Kam, Cheuk-wai; Ng, Lorna V.; Zee, Benny C.Y.
• Is Part Of: Family medicine and community health. Volume 4:Issue 4(2016)
• Page Start: 13
• Page End: 21
• Publication Date: 2016-12-01
• Subjects: Hypertensive retinopathy -- retinal photograph -- primary care; Family medicine -- Periodicals; Public health -- Periodicals; Family medicine; Public health; Family Practice; Community Health Services; General Practice; Electronic journals; Periodicals; Periodical; 610.5
• DOI: 10.15212/FMCH.2016.0114
• Languages: English
• ISSNs: 2305-6983

Abstract

Abstract : Objective: The objective is to estimate the prevalence and grading of hypertensive retinopathy in the primary care setting; examine the patient characteristics associated with hypertensive retinopathy; and examine the association of hypertensive retinopathy and other hypertension complications. Methods: This is a retrospective cross-sectional study. Subjects included adult hypertensive patients with available and gradable retinal photographs. Results: Two hundred fifty-six male hypertensive patients (34.3%) and 491 female hypertensive patients (65.7%) were included. The average duration of hypertension was 7.2 years, and 49.8% and 41.2% of patients were taking one or two antihypertensive medications respectively. Among 1491 qualified retinal photographs (744 right eye and 747 left eye), 24.9%, 62.6%, and 12.5% were classified as showing normal, mild, and moderate hypertensive retinopathy respectively. The three commonest retinal signs were generalized or focal arteriolar narrowing (650 cases, 43.6%), hard exudates (168 cases, 11.3%), and opacity (copper or silver wiring) of the arteriolar wall (166 cases, 11.1%). Patients older than 61 years, having hypertension for more than 15 years, or taking three or more antihypertensive medications were significantly associated with hypertensive retinopathy ( P <0.05). Conclusion: In a primary care clinic in Hong Kong, 77.1% of hypertensive patients had hypertensive retinopathy. Advanced hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.