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The association of severity of retinal vascular changes and cardiac remodelling in systemic hypertension

Mary Varghese1, Srilakshmi M Adhyapak2, Tinku Thomas3

  • 1Additional Professor and Head, Vitreo-Retinal Unit, Department of Ophthalmology, St. John's Medical College & Hospital, Bangalore, India.

Therapeutic Advances in Cardiovascular Disease
|February 17, 2016
PubMed

Insights

Severe hypertensive retinopathy (grades 3-4) is linked to significant cardiac remodeling, including left ventricular strain and reduced ejection fraction. Early retinopathy shows minimal cardiac changes, highlighting its importance in assessing hypertensive heart disease.

Area of Science:

  • Cardiology
  • Ophthalmology
  • Nephrology

Background:

  • Hypertension is a leading cause of cardiovascular and renal disease.
  • Hypertensive retinopathy reflects systemic vascular damage and may indicate end-organ damage.

Purpose of the Study:

  • To investigate the association between hypertensive retinopathy severity and cardiac remodeling.
  • To explore the relationship between hypertensive retinopathy grades and target organ damage.

Main Methods:

  • Cross-sectional observational study of 500 hypertensive inpatients.
  • Fundoscopy for hypertensive retinopathy grading.
  • Electrocardiography (ECG) and echocardiography for cardiac remodeling assessment.
  • Screening for other target organ damage.

Main Results:

  • Grades 3-4 retinopathy significantly associated with ECG findings (LV strain, left atrial enlargement) and echocardiographic findings (LVH, reduced LVEF).
  • Higher diastolic BP correlated with retinopathy.
  • Cardiac remodeling was absent in patients without retinopathy and uncommon in grades 1-2.
  • Patients with severe retinopathy had higher creatinine and increased heart failure incidence.

Conclusions:

  • Severe hypertensive retinopathy (grades 3-4) strongly correlates with cardiac remodeling and heart failure.
  • Diastolic BP, not systolic BP or hypertension duration, is linked to retinopathy.
  • Absence or mild retinopathy suggests minimal hypertensive heart disease.
Abstract

Keywords:
diabetes mellitushypertensionischaemiaretinopathytarget organ damage

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