The usefulness of ophthalmoscopy in risk evaluation of hypertensive patients.
OBJECTIVE
The main objective was to assess whether systematic ophthalmoscopy in the baseline evaluation of hypertensive patients results in a change in the therapeutic attitude as a result of the discovery of target organ damage. A secondary objective was to find the relationship between fundus lesions and other target organ manifestations in patients with hypertension.


RESULTS
73.6% of the patients studied had damage to the optic fundus, 35% of the patients had fundus lesions attributable to hypertension, 21% of patients (p < 0.001) (JNC-VI) and 15.8% (p < 0.001) (WHO/ISH) changed group of risk. Patients who were more likely to change group of risk after ophthalmoscopy were those with moderate hypertension (Grade II). Patients with a level of creatinine <85 micromol/l (WHO/ISH and JNC-VI), female and middle-aged patients (WHO/ISH) and patients older than 63 (JNC-VI) were also more likely to change groups. Hypertension grades II/III, creatinine >85 micromol/l and body mass index increase the risk of fundus lesions. Females are less at risk and alcohol intake seems to have a protective effect.


CONCLUSIONS
Ophthalmoscopy in the baseline evaluation of patients with hypertension permits a better stratification of risk.
Coll de Tuero
Gabriel
G
Angelès Community Health Centre, Girona, Spain. gcolld@meditex.es
Foguet Boreu
Quintí
Q
Vargas Vila
Susanna
S
Saez Zafra
Marc
M
Barceló Rado
Ma Antonia
MA
D000368:Aged; D000375:Aging / Q000502:physiology; D003404:Creatinine / Q000097:blood; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000592:standards*; D012044:Regression Analysis; D018570:Risk Assessment
D003404:Creatinine