Prevalence and Risk Factors of Hypertensive Retinopathy in Hypertensive Patients in a Tertiary Hospital of Gandaki Province of Nepal

  • Srijana Thapa Godar Manipal College of Medical Sciences, Pokhara, Nepal. https://orcid.org/0000-0002-0699-2464
  • Khem Raj Kaini Manipal College of Medical Sciences, Pokhara, Nepal.
Keywords: Hypertension, Hypertensive retinopathy, Prevalence, Risk factors

Abstract

Introduction: Hypertensive retinopathy is one of the major complications of hypertension. The presence of hypertensive retinopathy may be an indicator of the presence of other complications too. This study aimed to determine the prevalence and risk factors of hypertensive retinopathy in hypertensive patients in a tertiary care hospital in Nepal. Methods: This was a hospital-based cross-sectional study conducted among 95 hypertensive patients aged 30 years and above. Standard proforma was used to collect socio-demographic and clinical variables of the patients. Detailed eye examination including fundus evaluation under mydriasis was done on all patients and hypertensive retinopathy was graded according to Keith-Wagener-Barker classification. Statistical analysis was carried out using Epi-info 7. Results: The mean age of the study sample was 59.74±15.11 years. The prevalence of hypertensive retinopathy was 38.95%. Among the patients with hypertensive retinopathy, the prevalence of grade I, II, III, and IV retinopathies were 7.36%, 17.89%, 10.52%, and 3.15% respectively. There was a statistically significant association between hypertensive retinopathy and controlled blood pressure and treatment of hypertension. However, there was no statistically significant association between hypertensive retinopathy and gender, duration of hypertension, residence, family history, history of smoking, and diet. Conclusion: Uncontrolled blood pressure and untreated patients of hypertension were the significant risk factors for hypertensive retinopathy. Early diagnosis and treatment of hypertension are essential to prevent loss of vision.

Downloads

Download data is not yet available.

Author Biographies

Srijana Thapa Godar, Manipal College of Medical Sciences, Pokhara, Nepal.

Assistant Professor,

Department of Ophthalmology.

Khem Raj Kaini, Manipal College of Medical Sciences, Pokhara, Nepal.

Professor,

Department of Ophthalmology.

References

Hajjar I, Kotchen JM, Kotchen TA. Hypertension: trends in prevalence, incidence, and control. Annu Rev Public Health. 2006;27(0):465-90. PMID: 16533126. DOI: https://doi.org/10.1146/annurev.publhealth.27.021405.102132

National Institute of Health, National High Blood Pressure Education Program. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993;153(2):154-83. PMID: 8422206. DOI: https://doi.org/10.1001/archinte.1993.00410020010002

Wong TY, Mitchell P. Hypertensive retinopathy. The New England Journal of Medicine. 2004;351(0):2310-7. DOI: https://doi.org/10.1056/NEJMra032865

Tso MO, Jampol LM. Pathophysiology of hypertensive retinopathy. Ophthalmology. 1982;89(10):1132-45. PMID: 7155524. DOI: https://doi.org/10.1016/s0161-6420(82)34663-1

Keith NM, Wagener HP, Barker NW. Some different types of essential hypertension: their course and prognosis. Am J Med Sci. 1974;268(6):336-45. PMID: 4616627. DOI: https://doi.org/10.1097/00000441-197412000-00004

Wong TY, Klein R, Klein BE, Tielsch JM, Hubbard L, Nieto FJ. Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality. Surv Ophthalmol. 2001;46(1):59-80. PMID: 11525792. DOI: https://doi.org/10.1016/s0039-6257(01)00234-x

Karki KJD. Incidence of ophthalmoscopic fundus changes in hypertensive patients. Kathmandu Univ Med J. 2003;1(1):27-31. PMID: 16340257

Mondal RN, Matin MA, Rani M, Hossain MZ, Shaha AC, Singh RB, et al. Prevalence and Risk Factors of Hypertensive Retinopathy in Hypertensive Patients. Journal of Hypertension. 2017:6(2):1000241. DOI: https://doi.org/10.4172/2167-1095.1000241

Klein R, Klein BE, Moss SE, Wang Q. Hypertension and retinopathy, arteriolar narrowing, and arteriovenous nicking in a population. Arch Ophthalmol. 1994;112(1):92-8. PMID: 8285901. DOI: https://doi.org/10.1001/archopht.1994.01090130102026

Shantha GP, Srinivasan Y, Kumar AA, Salim S, Prabakhar S, Rajan AG, et al. Can retinal changes predict coronary artery disease in elderly hypertensive patients presenting with Angina? Am J Emerg Med. 2010;28(5):617-21. PMID: 20579560, DOI: https://doi.org/10.1016/j.ajem.2009.04.007

Besharati MR, Rastegar A, Shoja MR, Maybodi ME. Prevalence of retinopathy in hypertensive patients. Saudi Med J. 2006;27(11):1725-8. PMID: 17106550

Pun CB, Tuladhar S. Profile of Hypertensive Retinopathy in a Tertiary Center in Western Nepal. Journal of Gandaki Medical College- Nepal. 2019;12(1):22-4. DOI: https://doi.org/10.3126/jgmcn.v12i1.22607

Adhikari BN, Gautam PS, Bekoju B, Basnet S, Bhandari H. Association of Hypertensive Retinopathy with different serum lipid parameters in patients of Essential Hypertension: A Hospital Based Study. Journal of Nobel Medical College. 2018;7(2):50-7. DOI: https://doi.org/10.3126/jonmc.v7i2.22308

Erden S, Bicakci E. Hypertensive retinopathy: incidence, risk factors, and comorbidities. Clin Exp Hypertens. 2012;34(6):397-401. PMID: 22468968. DOI: https://doi.org/10.3109/10641963.2012.663028

Kabedi NN, Mwanza JC, Lepira FB, Kayembe TK, Kayembe DL. Hypertensive retinopathy and its association with cardiovascular, renal and cerebrovascular morbidity in Congolese patients. Cardiovasc J Afr. 2014;25(5):228-32. PMID: 25629539. DOI: https://doi.org/10.5830/cvja-2014-045

Kayange PC, Schwering MS, Manda CS, Singini I, Moyo VVP, Kumvenda J. Prevalence and clinical spectrum of hypertensive retinopathy among hypertension clinic patients at Queen Elizabeth Central Hospital in Malawi. Malawi Med J. 2018;30(3):180-3. PMID: 30627353. DOI: https://doi.org/10.4314/mmj.v30i3.9

Manjomo RC, Mwagomba B, Ade S, Ali E, Ben-Smith A, Khomani P, et al. Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi. Public Health Action. 2016;6(2):60-5. PMID: 27358797. DOI: https://doi.org/10.5588/pha.16.0003

Wood R, Viljoen V, Van Der Merwe L, Mash R. Quality of care for patients with non-communicable diseases in the Dedza District, Malawi. Afr J Prim Health Care Fam Med. 2015;7(1):838. PMID: 26245609. DOI: https://doi.org/10.4102/phcfm.v7i1.838

Klein R, Klein BE, Moss SE. The relation of systemic hypertension to changes in the retinal vasculature: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 1997;95:329-50. PMID: 9440178. PMCID: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1298366/

Badhu BP, Shrestha JK. Hypertensive patients in eye OPD, TUTH. Journal of Institute of Medicine 1998;20(0):188-92.

Published
2020-12-30
How to Cite
1.
Godar ST, Kaini KR. Prevalence and Risk Factors of Hypertensive Retinopathy in Hypertensive Patients in a Tertiary Hospital of Gandaki Province of Nepal. J Lumbini Med Coll [Internet]. 30Dec.2020 [cited 21Jan.2021];8(2):5 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/374
Section
Original Research Article