Relationship of Hypertensive Retinopathy to Thoracic Aortic Atherosclerosis in Patients with Severe Arterial Hypertension

Abstract

Arterial hypertension complicated with atherosclerosis presents the most common cause of death in hypertensive patients. Eyes suffer vascular damage as a result of high blood pressure (BP) and these changes can be detected by funduscopy, although its role has recently been questioned. The aims of this study were to assess the prevalence of atherosclerotic plaques and other disorders of thoracic aorta by transesophageal echocardiography (TEE) in patients with severe arterial hypertension of at least 1 year duration and to analyze the association between aortic atherosclerotic plaques and hypertensive retinopathy. This was a prospective TEE study conducted on 56 hypertensive patients from September 2008 to January 2010. Mean patient age was 62.8 ± 8.2 years and 67.86% of them were women. Aortic atherosclerotic plaques were found on 96.4% of patients, whereas hypertensive retinopathy was present on 94.6% of them. The mean thickness of maximal atherosclerotic plaque found on each patient was 4.3 ± 1.9 mm and 28.6% of patients had ulcerative plaques, while descending aorta was the most common location of the lesions. Grade 1 and 2 hypertensive retinopathy was diagnosed in 14.3% and 80.3% of patients, respectively. Hypertensive retinopathy correlated highly with aortic atherosclerotic score (r = 0.76, p < 0.0001), as it correlated significantly with aortic plaque thickness (r = 0.69, p < 0.0001). Application of funduscopy should be encouraged since it is a noninvasive procedure that provides a good window of retinal arterioles. Hypertensive retinopathy, even in mild forms, should serve as a marker of atherosclerosis elsewhere in the organism.

Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive chinese adults

“…Many studies have proved the value of the retinal vascular in predicting the severity of target organ damage, including cardiovascular, renal and cerebrovascular disease [5, 6]. The prevalence of HR in hypertensive patients varied among different researches (30.6%–94.6%) [7–9]. To date there has been no large sample, epidemiologic statistical reports on HR in China.…”

Hypertensive retinopathy

“…Strong association with risk of incident stroke [23,24], cardiovascular mortality [29], cognitive decline [42], transient ischemic attack, and acute ischemic stroke [30], and stroke mortality [31] …”

Modern Aspects of Hypertensive Angioretinopathy

“…Значимое исследование гипертонической ретинопатии проведено A. Bakalli и соавт. [20]. Была выявлена взаимосвязь гипертонической ретинопатии с наличием аортальных атеросклеротических бляшек в грудном отделе аорты.…”

“…Гипертоническая ретинопатия коррелировала с атеросклеротическими показателями аорты (r = 0,76, p < 0,0001), а также с толщиной бляшки аорты (r = 0,69, p < 0,0001). Это доказывает важность диагностики гипертонической ретинопатии даже при ранних стадиях для оценки атеросклеротического процесса в других отделах организма [20].…”