Hypertensive Eye Ground Changes

Abstract

ABSTRACT. As part of a prospective population study of cardiovascular disease, ophthalmoscopic examination was performed in 855 randomly selected 50‐year‐old men in 1963. The examination was repeated four years later, in 1967. On both occasions haemorrhages, exudates and papillary aedema were rarely seen. Attenuating arterioles, focal narrowing, crossing phenomena and broadened light reflex were all related to BP but attenuating arterioles and/or focal narrowing discriminated BP best. Isolated broadened reflex and/or crossing phenomena were not related to BP. The change in BP over four and ten years was the same in those who had and those who did not have hypertensive eye ground changes at the initial examination, indicating that eye ground changes do not precede hypertension. Mortality data and the morbidity in myocardial infarction and stroke were followed up until 1975. The importance of the separate eye ground variables for these mortality and morbidity end‐points was analyzed, taking into account the importance of BP, serum cholesterol and smoking. Focal narrowings were of importance for mortality, regardless of its cause, for stroke and for death from malignancy. Crossing phenomena were of importance for mortality, regardless of cause, for fatal coronary heert disease, for stroke and for deaths other than cardiovascular and cancer deaths. The eye ground variables are thus of differing importance for different end‐points. Grouping them as in Keith and Wagener's or other classification systems, means a loss of information and should be avoided.