Ophthalmological Investigations of 500 Persons with Hypertension of Long Duration

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…326,328 In a study of people with nonmalignant hypertension of at least 10 years duration, 33% had no fundoscopic changes, 37% had slight arteriolar narrowing (especially in older patients), and 6% had hemorrhages or lipid deposits. 329 In older patients, retinal vessel changes are less reliable indicators of the presence or duration of hypertension. For individual patients with hypertension, retinal findings may be reasonable indicators of organ damage.…”

Retinal Vascular Changes during Aging in Wistar Kyoto Rats

“…Other authors felt that age as well as hypertension may be associated with a degree of sclerosis of the retinal vessels. Bechgaard and Vogelius [16,17] found no differ ence in retinal vessel abnormalities between young hypertensive persons and elderly indi viduals with normal blood pressure. Evelyn et al [ 18] implied that age is an important factor in retinal arteriosclerosis, but in another pa per they indicated that age and diabetes may produce a picture in the retinal vessels identi cal to that caused by high blood pressure.…”

Hypertension and the eye

“…In young individuals with little involutional sclerosis, hypertensive narrowing will be more evident than in an elderly patient where vessels are more rigid due to involutional sclerosis. Arteriolar narrowing is associated with prolonged raised blood pressure, particularly diastolic [18], and age [13,23,41]. This arteriolar change is present in up to one third of systemic hypertensive patients and is thought to reflect systemic hypertension rather than arteriolar sclerotic changes [13].…”

“…several reasons: 1) it was based mainly on malignant hypertension, and has little prognostic value in those with less severe hypertension [13,14]; clinical allocation of patients between groups 1 and 2 is very subjective [15,16]; and group 3 and 4 only differ on the presence of papilledema, the presence of which does not influence the prognosis of a treated patient who already has bilateral retinal hemorrhages and exudates [17].…”

“…Arteriolar narrowing is associated with prolonged raised blood pressure, particularly diastolic [18], and age [13,23,41]. This arteriolar change is present in up to one third of systemic hypertensive patients and is thought to reflect systemic hypertension rather than arteriolar sclerotic changes [13]. Examination of the degree of arteriolar narrowing is best established beyond the second branch of the central retinal vessel or around the fovea [40].…”