Retinopathy as an indicator of silent brain infarction in asymptomatic hypertensive subjects.
OBJECTIVE
Silent brain infarction (SBI), which is cerebral target organ damage of hypertensive microangiopathies, is frequently seen in hypertensive patients. The purpose of this study is to investigate the relation between hypertensive retinopathy (HTR) and SBI in subjects without a history of stroke or transient ischemic attack.


METHODS
Five hundred-fifty hypertensive subjects without history of stroke or transient ischemic attack had brain MRI and retinal photographs taken. The presence of SBI was assessed from the MRI scans, which was defined as a lesion of at least 3 mm in diameter with typical imaging characteristics. The presence HTR was defined from digitized retinal photographs.


RESULTS
Seventy-seven subjects (14%) showed HTR (grade 1 in 46, grade 2 in 31 persons). A multivariate analysis showed that age (OR, 1.07; 95% CI, 1.03 to 1.10) and HTR (OR, 2.01 for grade 1; OR, 3.03 for grade 2) were the independent indicators for the presence of SBI. The higher the grade of HTR, the more prevalent SBI than persons with normal retina (by linear by linear association test, p=0.001).


CONCLUSIONS
HTR is associated with the presence of SBI. This finding suggests that retinal photography may be useful for identifying hypertensive subjects at increased risk of having SBI regardless of current blood pressure status.
Kwon
Hyung-Min
HM
Department of Neurology, Kyunghee University East-West Neo Medical Center, Seoul, Republic of Korea.
Kim
Beom Joon
BJ
Oh
Joo Youn
JY
Kim
Sang Jin
SJ
Lee
Seung-Hoon
SH
Oh
Byung-Hee
BH
Yoon
Byung-Woo
BW
D000368:Aged; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000473:pathology*