The association between retinal vessel abnormalities and H-type hypertension

Abstract

Background: This study aimed to investigate the relationship between H-type hypertension and retinal vessel abnormalities.

Methods: Hypertensive patients were retrospectively enrolled in this study. According to plasma homocysteine (HCY), patients were divided into isolated hypertension and H-type hypertension groups. The diameter of retinal vessels and retinopathy were evaluated by retinal fundus photography. The differences of retinal vessel abnormalities between H-type hypertension and isolated hypertension were investigated by univariate and multivariate regression.

Results: A total of 191 hypertensive patients were included, of which 86 were with isolated hypertension and 105 with H-type hypertension. The H-type hypertension group had a higher ratio of retinopathy(P = 0.004) and higher degree of retinal arteriosclerosis (P = 0.005) than the isolated hypertension group. CRAE (107.47 ± 13.99µ m vs. 113.49 ± 11.72µ m, P = 0.002) and AVR (0.55 ± 0.06 vs. 0.58 ± 0.06, P = 0.001) were smaller in H-type hypertension group than those in isolated hypertension group. Multivariate analysis showed that after adjusting for age, sex, course of hypertension and diabetes, H-type hypertension was an independent risk factor of retinopathy (OR, 2.259; 95%CI, 1.165-4.378; P = 0.016), CRAE (β=-5.669; 95%CI, -9.452--1.886; P = 0.004), and AVR (β=-0.023; 95%CI, -0.039--0.007; P = 0.005).

Conclusions: H-type hypertension is closely related to more retinal vessel abnormalities than isolated hypertension. Controlling H-type hypertension may reduce the risk of small vascular damage.

Keywords: Homocysteine; Hypertension; Retinal vessel abnormality.

Fig. 1

Retinal fundus photographs of patients. a, Arteriovenous nicking (upper arrow), normal retinal artery (magnified at the lower arrow); b, Retinal arteriosclerosis (magnified at the arrow), The retinal artery becomes thinner, the reflection is enhanced, and the blood column becomes lighter in color; c, Retinal artery is widely wavy (arrow point). d, Hemorrhage of the retina (arrow point); e, Microangioma (upper arrow), hard exudation (lower arrow); f, Soft exudate (arrow point)