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Open Access Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs

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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.
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Keywords: Hypertensive retinopathy; primary care; retinal photograph

Document Type: Research Article

Publication date: 01 December 2016

More about this publication?
  • Family Medicine and Community Health (FMCH) is an open-access journal focusing on subjects that are common and relevant to family medicine/general practice and community health. The journal publishes relevant content across disciplines such as epidemiology, public health, social and preventive medicine, research and evidence based medicine, community health service, patient education and health promotion and health ethics. The journal has a specific focus on the management of chronic illness particularly diabetes, ischaemic heart disease, chronic heart failure, hypertension, bronchial asthma, chronic obstructive airways disease and common mental illness. FMCH is published by Compuscript on behalf of the Chinese General Practice Press

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