Systemic Hypertension and the Eye: Highlighting a Comorbidity

Marianne Shahsuvaryan

doi:10.4172/2155-9880.1000442

Abstract

Purpose: To identify ocular comorbidity in systemic hypertension. Methods: Research findings include data of 566 patients with RVO ( retinal vein occlusion) 408 and 158 patients with the central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) respectively, representing a cases and and 566 controls, all aged 31 years and older. Excluded from case and control group were persons with degenerative changes of retina and ocular inflammation. At the baseline examination blood pressures was measured and were tested fibrinogen, recalcification time, plasma tolerance to heparin, prothrombin ratio for evaluation of blood coagulability. A statistical analysis was conducted by a commercially available statistical software package. Results: Among our cases hypertension was more prevalent with an elevated systolic and diastolic blood pressures comparing to controls. Hypercoagulability represented by elevated prothrombin ratio has shown a close association with age and RVO, evidencing higher risk of vasoocclusion in older persons with hypercoagulability. It was found that higher blood pressure: systolic blood pressure (OR, 8.49; 95% CI, 4.81 to 15.13) and diastolic blood pressure (OR, 9.37; 95% CI, 6.34 to 13.89); prothrombin ratio (OR, 4.0; 95% CI, 2.17 to 7.7) after adjusting for age and sex, plays a significant role in the development of RVO. Assessing an impact of systemic hypertension duration on RVO frequency it was evidenced direct relationship indicating increased cases of RVO in patients suffering from systemic hypertension 5-10 years and more obvious impact in case of longer duration–more than 10 years. Conclusions: The study emphasized the need for enhanced collaboration between specialties to ensure appropriate management of patients with systemic hypertension and ocular comorbidity in order to prevent occurrence of retinal vein occlusion.

Highlights

Accumulating evidence based on aging population suggests a worldwide epidemic of systemic hypertension, which represents a major risk factor for cardial, cerebral vascular disease
Several risk factors were significantly associated with Retinal vein occlusion (RVO) in the screening analyses (Table 2)
Hypercoagulability represented by elevated prothrombin ratio has shown a close association with age and RVO, evidencing higher risk of vasoocclusion in older persons with hypercoagulability

Summary

Introduction

Accumulating evidence based on aging population suggests a worldwide epidemic of systemic hypertension, which represents a major risk factor for cardial, cerebral vascular disease. In the United States approximately 75 million adults are affected by systemic hypertension [1]. According to a new analysis of data from the Nationwide Emergency Department Sample [2] it was evidenced increase by quarter emergency rooms visits for essential hypertension during 2006-2011 years. The prevalence of systemic hypertension dramatically increases in patients older than 60 years [3], reaching 50% in many countries. It is recognized that there is a drive towards increased cases worldwide up to 20% of adult population. Present definition of hypertension is a systolic blood pressure (SBP) of 140 mm Hg or higher, or a diastolic blood pressure (DBP) of 90 mm Hg or higher, or taking antihypertensive medication [4]

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