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. 2021 Nov;28(6):613-618.
doi: 10.1007/s40292-021-00481-7. Epub 2021 Oct 28.

Hypertensive Retinopathy and All-Cause Mortality in Older Adults of Amerindian Ancestry. A Population-based Longitudinal Prospective Study

Oscar H Del Brutto  1 , Robertino Mera  2 , Bettsy Y Recalde  3 , Denisse A Rumbea  3 , Aldo F Costa  4 , Eduardo Viteri  5
Affiliations

Hypertensive Retinopathy and All-Cause Mortality in Older Adults of Amerindian Ancestry. A Population-based Longitudinal Prospective Study

Oscar H Del Brutto et al. High Blood Press Cardiovasc Prev. 2021 Nov.

Abstract

Introduction: Hypertensive retinopathy (HTRP) predicts all-cause mortality in Asian and Caucasian populations. However, little is known about HTRP impact in other ethnic groups.

Aim: We sought to estimate the mortality risk according to HTRP severity in older adults of Amerindian ancestry living in rural Ecuador.

Methods: This prospective study enrolled individuals aged ≥ 60 years with baseline blood pressure ≥ 120/≥ 80 mmHg from the ongoing Atahualpa Project cohort who received retinal photographs (for HTRP grading) and a brain MRI. We ascertained all-cause mortality after a mean of 5.2 ± 1.2 years of follow-up. Cox-proportional hazards models adjusted for demographics, cardiovascular risk factors, neuroimaging signatures of cerebral small vessel disease, blood pressure determinations during follow-up and incident strokes, were obtained to estimate mortality risk according to HTRP severity.

Results: Analysis included 236 participants (mean age 69.3 ± 7.3 years). HTRP Grade 2 or higher was determined in 42 (18%) individuals. Fifty participants (21%) died during the follow-up, resulting in an overall unadjusted crude mortality rate of 4.1 per 100 person-years. Mortality rate in subjects with HTRP Grade 2 or higher was 7.2 and in those with no HTRP or Grade 1 only was 3.4 per 100 person-years. An adjusted Cox-proportional hazard model showed that individuals with HTRP Grade 2 or higher maintained a greater than two-fold mortality risk (HR 2.08; 95% C.I. 1.04-4.15; p = 0.038) when compared to those with no HTRP or Grade 1 only.

Conclusion: Study results show that HTRP severity predicts mortality in this population of older adults.

Keywords: Cerebral small vessel disease; Hypertensive retinopathy; Mortality; Population study; Prognosis.

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Conflict of interest statement

All authors report no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival curves and Hazard Ratios with 95% confidence intervals for all-cause mortality according to hypertensive retinopathy severity, adjusted for demographics and cardiovascular risk
See this image and copyright information in PMC

References

    1. http://www.emro.who.int/media/world-health-day/public-health-problem-fac....
    1. Piskorz D. Hypertensive mediated organ damage and hypertension management. How to assess beneficial effects of antihypertensive treatments? High Blood Press Cardiovasc Prev. 2020; 27: 9-17. - PubMed
    1. Shlomai G, Grassi G, Grossman E, Mancia G. Assessment of target organ damage in the evaluation and follow-up of hypertensive patients: Where do we stand? J Clin Hypertens (Greenwich) 2013;15:742–747. doi: 10.1111/jch.12185. - DOI - PMC - PubMed
    1. Wong TY, Klein R, Couper DJ, Cooper LS, Shahar E, Hubbard LD, et al, Sharrett AR. Retinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study. Lancet. 2001; 358: 1134-40. - PubMed
    1. Wong TY, McIntosh R. Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality. Br Med Bull. 2005;73–74:57–70. doi: 10.1093/bmb/ldh050. - DOI - PubMed

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