Sherif A. Sakr

Hypertensive retinopathy and coronary angiographic findings: is there a relationship?

Background The retina provides a window to study human circulation, but no data exist on the association between hypertensive retinopathy and the risk of coronary artery disease (CAD) in middle-aged hypertensive patients. Participants and methods We studied 62 consecutive hypertensive nondiabetic patients referred to our catheterization laboratory for coronary angiography (CAG) because of suspected CAD. CAD burden was quantified using the Duke Myocardial Jeopardy scoring system. Direct ophthalmoscopy and photography was performed, and the retinal signs obtained were graded according to the modified Scheie classification. Eligible patients, 57±8.3 years of age, underwent CAG. About 52% of patients were diagnosed with significant CAD, 29% had multivessel disease, and 25% had coronary ectasia. Hypertensive retinopathy was present in 92% of CAD patients; 50% had low-grade retinopathy and 42% had high-grade retinopathy. Results The grades of retinopathy were not associated with copresentation of ectasia or various CAG findings in any of the three main coronary vessels. Similarly, no association was found in the extent of ectasia (focal vs. diffuse) or the number of coronary vessels affected. No statistically significant associations were found between the grades of retinopathy and median or log-transformed values of the Duke score. Conclusion No retinal changes of any grade were associated with the presence or severity of CAD and thus may not be used to screen for CAD in hypertensive patients.