The usefulness of ophthalmoscopy in risk evaluation of hypertensive patients

The main objective was to assess whether systematic ophthalmoscopy in the baseline evaluation of hypertensive patients results in a change in the therapeutic attitude as a result of the discovery of target organ damage. A secondary objective was to find the relationship between fundus lesions and other target organ manifestations in patients with hypertension.

73.6% of the patients studied had damage to the optic fundus, 35% of the patients had fundus lesions attributable to hypertension, 21% of patients (p < 0.001) (JNC-VI) and 15.8% (p < 0.001) (WHO/ISH) changed group of risk. Patients who were more likely to change group of risk after ophthalmoscopy were those with moderate hypertension (Grade II). Patients with a level of creatinine <85 micromol/l (WHO/ISH and JNC-VI), female and middle-aged patients (WHO/ISH) and patients older than 63 (JNC-VI) were also more likely to change groups. Hypertension grades II/III, creatinine >85 micromol/l and body mass index increase the risk of fundus lesions. Females are less at risk and alcohol intake seems to have a protective effect.

Ophthalmoscopy in the baseline evaluation of patients with hypertension permits a better stratification of risk.