Hypertensive retinopathy and its association with cardiovascular, renal and cerebrovascular morbidity in Congolese patients : cardiovascular topic

Abstract

SummaryBackgroundSigns indicating hypertensive retinopathy can help determine the extent of hypertensive cardiovascular, renal and cerebrovascular damage.ObjectivesTo study the association between hypertensive retinopathy and cardiovascular, renal and cerebrovascular changes, and to determine the predictors of hypertensive retinopathy in Congolese patients.MethodsA total of 159 hypertensive subjects (mean age: 58.9 ± 13.2 years) were enrolled from the cardiology out-patient clinic. Retinopathy grade was assessed on direct ophthalmoscopy. Hypertensive cardiovascular, renal and cerebrovascular changes were indicated by left ventricular hypertrophy (LVH), chronic kidney disease (CKD) and stroke, respectively.ResultsHypertensive retinopathy was present in 83.6% of the patients (grade 1: 42.1%; grade 2: 11.3%; grade 3: 23.3%; grade 4: 6.9%). There was no association between hypertensive retinopathy and the presence or absence of LVH (86.5 vs 73.3%, χ2 = 1.53, p = 0.21), chronic kidney disease (89.3 vs 83.3%, χ2 = 0.12, p = 0.73) or stroke (85.7 vs 83.2%, χ2 > 0.001, p = 0.99). On multivariate logistic regression, CKD was the most significant predictor of severe hypertensive retinopathy, with an odds ratio of 4.4.ConclusionNo association was found between hypertensive retinopathy and LVH, CKD or stroke. CKD was the most significant predictor of hypertensive retinopathy and there was a tendency toward increased risk of target-organ damage among patients with advanced hypertensive retinopathy.

Hypertension in a resource‐limited setting: Is it associated with end organ damage in older adults in rural Tanzania?

“…Hypertension has been previously identified as the single strongest predictor of stroke in Hai district . We found proteinuria to be present in a fifth of hypertensives, similar to rates of proteinuria reported in younger rural dwelling Nigerians and the prevalence of other markers for renal impairment reported in hypertensives from Nigeria and Congo . Coresh et al reported the prevalence of chronic kidney disease, defined by reduced GFR and albuminuria, in the US population of people aged over 70 years as 13.1%, similar to that found in our complete cohort of a similar age.…”

“…No comparison was made with normotensives. In the Democratic Republic of Congo, Kabedi et al found high rates of EOD amongst hypertensives (53.6% had LVH, 31.8% had chronic kidney disease and 17.6% had a previous stroke), supporting the findings from Nigeria. Studies in Ethiopia and Ghana have also been conducted, with renal impairment, stroke, and LVH common in hypertensives …”

Hypertensive Retinopathy - Prevalence, Risk Factors and Comorbids

“…These results are similar to that of the study by Kabedi et al 11 In a study conducted by Tien Y Wong et al 10 after controlling for systolic blood pressure, diabetes, glycosylated haemoglobin levels and other risk factors, retinopathy was associated with increased cardiovascular mortality.…”

Risk factors for hypertensive retinopathy in a Chinese population with hypertension: The Beijing Eye study

“…Epidemiological studies, conducted in Chinese patients with hypertension, have indicated that 67-73% of patients have fundus lesions and 12-15% have retinopathy (3,4). Hypertensive retinopathy is a risk factor for stroke (5), cardiovascular disease (6,7) and cerebrovascular disease (8). Therefore, it is important to study the risk factors of retinopathy in hypertensive patients, in order to reduce the incidence of hypertensive retinopathy and associated cardiovascular and cerebrovascular diseases (9,10).…”