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DESPITE LIMITED BENEFIT, FUNDUSCOPIC EXAMINATION SHOULD BE CONTINUED FOR HYPERTENSION*

Year 2010, Volume: 1 Issue: 2, 1 - 6, 03.03.2015
https://doi.org/10.5799/ahinjs.01.2013.04.0324

Abstract

funduscopic examination should be continued for HT until demonstration of some more accurate follow up criteria. their specificities for HT are probably higher, particularly for hypertensive crises. Therefore, although limited benefit, Additionally, although the lower incidences and even additional atherosclerotic backgrounds of grade III and IV HRs, benefits of funduscopic examination in management of HT due to limited number of available parameters in this field. higher prevalence of grade II HRs in the HT group indicate the effects of HT on retinal vasculature, and probable Conclusion: Although HR is not a specific sign of HT, the significantly lower prevalence of grade 0 and significantly p<0.01) in the HT group.
significantly lower (55.4% versus 32.6%, p<0.01) and grade II HR was significantly higher (4.0% versus 13.0%, detected in any group. Differences were nonsignificant according to prevalence of grade I HR whereas grade 0 HR was 28.2%, p<0.01) were significantly higher in the HT group. No case of grade III or IV hypertensive retinopathy (HR) was the groups, whereas prevalences of obesity (27.0% versus 54.3%, p<0.001) and hypertriglyceridemia (13.5% versus gender distribution, and prevalences of smoking, diabetes mellitus, hyperbetalipoproteinemia, and dyslipidemia between Results: We studied 74 cases with NT and 46 with HT. There were nonsignificant differences according to the mean age, Medicine Polyclinic. Methods: The study was performed on consecutive check up patients with normotension (NT) and HT in Internal mainstay for prevention of cardiovascular diseases. B

References

  • Ezzati M, Lopez AD, Rodgers A, Vander Hoorn
  • S, Murray CJ: Comperative Risk Assessment
  • Collaborating Group. Selected major risk factors
  • and global and regional burden of disease.
  • Lancet 2002; 360: 1347-1360.
  • Chobanian AV, Bakris GL, Black HR, Cushman
  • WC, Green LA, Izzo JL Jr, et al. Seventh Report
  • of the Joint National Committee on Prevention,
  • Detection, Evaluation, and Treatment of High
  • Blood Pressure. Hypertension 2003; 42: 1206-
  • -
  • Helvaci MR, Seyhanli M. What a high
  • prevalence of white-coat hypertension in society!
  • Intern Med 2006; 45: 671-674.
  • Akdeniz B, Goldeli O, Baris N. Blood pressure
  • control rates in hypertensive patients and their
  • determining factors in two urban regions of
  • Izmir. Anadolu Kardiyol Derg 2005; 5: 133-134.
  • Turkish
  • O'Brien E, Asmar R, Beilin L, Imai Y, Mallion
  • JM, Mancia G, et al. European Society of
  • Hypertension recommendations for
  • conventional, ambulatory and home blood
  • pressure measurement. J Hypertens 2003; 21:
  • –848.
  • Helvaci MR, Kaya H, Seyhanli M, Cosar E.
  • White Coat Hypertension Is Associated with a
  • Greater All-cause Mortality. J Health Sci 2007;
  • : 156-160.
  • Helvaci MR, Kaya H, Yalcin A, Kuvandik G.
  • Prevalence of white coat hypertension in
  • underweight and overweight subjects. Int Heart J
  • ; 48: 605-613.
  • Mandava N, Yannuzzi LA. Hypertensive
  • Retinopathy. In: Regillo CD, Brown GC, Flynn
  • HW Jr, eds. Vitreoretinal Disease: The
  • Essentials. New York: Thieme; 1999: 193-196.
  • Third Report of the National Cholesterol
  • Education Program (NCEP) Expert Panel on
  • Detection, Evaluation, and Treatment of High
  • Blood Cholesterol in Adults (Adult Treatment
  • Panel III) final report. Circulation 2002; 17:106:
  • -3421.
  • Ohkubo T, Asayama K, Kikuya M, Metoki H,
  • Hoshi H, Hashimoto J, et al. How many times
  • should blood pressure be measured at home for
  • better prediction of stroke risk? Ten-year followup
  • results from the Ohasama study. J Hypertens
  • ; 22: 1099–1104.
  • Ridker PM, Libby P. Risk Factors for
  • Atherothrombotic Disease. In Douglas P. Zipes,
  • Peter Libby, Robert O. Bonow, Eugene
  • Braunwald (eds): Braunwald’s Heart Disease: A
  • Textbook of Cardiovascular Medicine 7th Ed.
  • Philadelphia, Pennsylvania, Elsevier Saunders
  • ; 939-958.
  • Cuspidi C, Salerno M, Salerno DE, Meani S,
  • Valerio C, Esposito A, et al. High prevalence of
  • retinal vascular changes in never-treated
  • essential hypertensives: an inter- and intraobserver
  • reproducibility study with nonmydriatic
  • retinography. Blood Press 2004; 13:
  • -30.
  • Van den Born BJ, Schlingemann RO, Hoekstra
  • JB, van Montfrans GA. Routine funduscopic
  • examination in hypertensive patients not useful.
  • Ned Tijdschr Geneeskd 2004; 148: 464-468.
  • Raczynska K, Potaz P, Aleszewicz-Baranowska J.
  • Epidemiology of hypertensive retinopathy in
  • young patients after coarctation of the aorta
  • repair. Klin Oczna 2004; 106: 456-459.
  • Fuchs FD, Maestri MK, Bredemeier M, Cardozo
  • SE, Moreira FC, Wainstein MV, et al. Study of
  • the usefulness of optic fundi examination of
  • patients with hypertension in a clinical setting. J
  • Hum Hypertens 1995; 9: 547-551.
  • Takiuchi S, Kamide K, Miwa Y, Tomiyama M,
  • Yoshii M, Matayoshi T, et al. Diagnostic value of
  • carotid intima-media thickness and plaque score
  • for predicting target organ damage in patients
  • with essential hypertension. J Hum Hypertens
  • ; 18: 17-23.
  • Luft FC, Agrawal B. Microalbuminuria as a
  • predictive factor for cardiovascular events. J
  • Cardiovasc Pharmacol 1999; 33: 11-15.
  • Palatini P, Penzo M, Bongiovi S, Canali C,
  • Pessina AC. Role of ophthalmoscopy in arterial
  • hypertension: a problem revisited. Cardiologica
  • ; 36: 713-722.
  • Besharati MR, Rastegar A, Shoja MR, Maybodi
  • ME. Prevalence of retinopathy in hypertensive
  • patients. Saudi Med J 2006; 27: 1725-1728.
  • Helvaci MR, Ozcura F, Kaya H, Yalcin A.
  • Funduscopic Examination Has Limited Benefit
  • for Management of Hypertension. Int Heart J
  • ; 48: 187-194.
  • Skalina ME, Annable WL, Kliegman RM,
  • Fanaroff AA. Hypertensive retinopathy in the
  • newborn infant. J Pediatr 1983; 103: 781-786.

DESPITE LIMITED BENEFIT, FUNDUSCOPIC EXAMINATION SHOULD BE CONTINUED FOR HYPERTENSION

Year 2010, Volume: 1 Issue: 2, 1 - 6, 03.03.2015
https://doi.org/10.5799/ahinjs.01.2013.04.0324

Abstract

Amaç: Hipertansiyon (HT), ciddi kardiyovasküler olay riskini arttırmaktadır, bu sebeple kan basıncı kontrolü
kardiyovasküler hastalıkların önlenmesinde ana unsurdur.
Metotlar: Çalışma, İç Hastalıkları Polikliniùinde ardı sıra başvuran normal tansiyon (NT) vakası ve HT hastalarında
yapıldı.
Sonuçlar: Yetmiş dört NT vakası ve 46 HT hastası çalışmaya alındı. Gruplar arasında ortalama yaş, cinsiyet ve sigara,
diyabet, hiperbetalipoproteinemi ve dislipidemi prevelansları açısından istatistiksel olarak anlamlı bir farklılık yoktu. Ancak
obezite (%27.0’a karşılık %54.3, p<0.001) ve hipertrigliseridemi (%13.5’e karşılık %28.2, p<0.01) prevelansları HT
grubunda anlamlı şekilde yüksekti. Her iki grupta da hiçbir grade III veya IV hipertansif retinopati (HR) vakasına
rastlanmadı. Gruplar arasındaki fark grade I HR prevelansı açısından anlamsızdı, ancak grade 0 HR prevelansı HT
grubunda anlamlı şekilde düşük iken (%55.4’e karşılık %32.6, p<0.01), grade II HR prevelansı anlamlı şekilde yüksekti
(%4.0’a karşılık %13.0, p<0.01).
Özet: Her ne kadar HR, HT’a spesifik bir bulgu deùilse de, HT grubunda tespit edilen grade 0 HR prevelansının anlamlı
düşüklüùü ve grade II HR prevelansının anlamlı yüksekliùi HT’un göz damarlanması üzerine olan etkilerini göstermekte
ve bu alanda mevcut kullanılabilir takip parametreleri sayısının kısıtlı olması nedeniyle muhtemel faydasına işaret
etmektedir. Ek olarak, her ne kadar toplumdaki insidanslarının düşük olması ve ilave ateroskleroz zeminlerine raùmen,
grade III ve IV HR’nin HT için, özellikle de hipertansif krizler için spesifisitesi muhtemelen yüksektir. Bu sebeple, her ne
kadar faydası kısıtlıysa da yeni bazı daha etkili takip kriterlerinin bulunmasına kadar HT hastalarının tanı ve takibinde
göz dibi muayenesine devam edilmelidir. 

References

  • Ezzati M, Lopez AD, Rodgers A, Vander Hoorn
  • S, Murray CJ: Comperative Risk Assessment
  • Collaborating Group. Selected major risk factors
  • and global and regional burden of disease.
  • Lancet 2002; 360: 1347-1360.
  • Chobanian AV, Bakris GL, Black HR, Cushman
  • WC, Green LA, Izzo JL Jr, et al. Seventh Report
  • of the Joint National Committee on Prevention,
  • Detection, Evaluation, and Treatment of High
  • Blood Pressure. Hypertension 2003; 42: 1206-
  • -
  • Helvaci MR, Seyhanli M. What a high
  • prevalence of white-coat hypertension in society!
  • Intern Med 2006; 45: 671-674.
  • Akdeniz B, Goldeli O, Baris N. Blood pressure
  • control rates in hypertensive patients and their
  • determining factors in two urban regions of
  • Izmir. Anadolu Kardiyol Derg 2005; 5: 133-134.
  • Turkish
  • O'Brien E, Asmar R, Beilin L, Imai Y, Mallion
  • JM, Mancia G, et al. European Society of
  • Hypertension recommendations for
  • conventional, ambulatory and home blood
  • pressure measurement. J Hypertens 2003; 21:
  • –848.
  • Helvaci MR, Kaya H, Seyhanli M, Cosar E.
  • White Coat Hypertension Is Associated with a
  • Greater All-cause Mortality. J Health Sci 2007;
  • : 156-160.
  • Helvaci MR, Kaya H, Yalcin A, Kuvandik G.
  • Prevalence of white coat hypertension in
  • underweight and overweight subjects. Int Heart J
  • ; 48: 605-613.
  • Mandava N, Yannuzzi LA. Hypertensive
  • Retinopathy. In: Regillo CD, Brown GC, Flynn
  • HW Jr, eds. Vitreoretinal Disease: The
  • Essentials. New York: Thieme; 1999: 193-196.
  • Third Report of the National Cholesterol
  • Education Program (NCEP) Expert Panel on
  • Detection, Evaluation, and Treatment of High
  • Blood Cholesterol in Adults (Adult Treatment
  • Panel III) final report. Circulation 2002; 17:106:
  • -3421.
  • Ohkubo T, Asayama K, Kikuya M, Metoki H,
  • Hoshi H, Hashimoto J, et al. How many times
  • should blood pressure be measured at home for
  • better prediction of stroke risk? Ten-year followup
  • results from the Ohasama study. J Hypertens
  • ; 22: 1099–1104.
  • Ridker PM, Libby P. Risk Factors for
  • Atherothrombotic Disease. In Douglas P. Zipes,
  • Peter Libby, Robert O. Bonow, Eugene
  • Braunwald (eds): Braunwald’s Heart Disease: A
  • Textbook of Cardiovascular Medicine 7th Ed.
  • Philadelphia, Pennsylvania, Elsevier Saunders
  • ; 939-958.
  • Cuspidi C, Salerno M, Salerno DE, Meani S,
  • Valerio C, Esposito A, et al. High prevalence of
  • retinal vascular changes in never-treated
  • essential hypertensives: an inter- and intraobserver
  • reproducibility study with nonmydriatic
  • retinography. Blood Press 2004; 13:
  • -30.
  • Van den Born BJ, Schlingemann RO, Hoekstra
  • JB, van Montfrans GA. Routine funduscopic
  • examination in hypertensive patients not useful.
  • Ned Tijdschr Geneeskd 2004; 148: 464-468.
  • Raczynska K, Potaz P, Aleszewicz-Baranowska J.
  • Epidemiology of hypertensive retinopathy in
  • young patients after coarctation of the aorta
  • repair. Klin Oczna 2004; 106: 456-459.
  • Fuchs FD, Maestri MK, Bredemeier M, Cardozo
  • SE, Moreira FC, Wainstein MV, et al. Study of
  • the usefulness of optic fundi examination of
  • patients with hypertension in a clinical setting. J
  • Hum Hypertens 1995; 9: 547-551.
  • Takiuchi S, Kamide K, Miwa Y, Tomiyama M,
  • Yoshii M, Matayoshi T, et al. Diagnostic value of
  • carotid intima-media thickness and plaque score
  • for predicting target organ damage in patients
  • with essential hypertension. J Hum Hypertens
  • ; 18: 17-23.
  • Luft FC, Agrawal B. Microalbuminuria as a
  • predictive factor for cardiovascular events. J
  • Cardiovasc Pharmacol 1999; 33: 11-15.
  • Palatini P, Penzo M, Bongiovi S, Canali C,
  • Pessina AC. Role of ophthalmoscopy in arterial
  • hypertension: a problem revisited. Cardiologica
  • ; 36: 713-722.
  • Besharati MR, Rastegar A, Shoja MR, Maybodi
  • ME. Prevalence of retinopathy in hypertensive
  • patients. Saudi Med J 2006; 27: 1725-1728.
  • Helvaci MR, Ozcura F, Kaya H, Yalcin A.
  • Funduscopic Examination Has Limited Benefit
  • for Management of Hypertension. Int Heart J
  • ; 48: 187-194.
  • Skalina ME, Annable WL, Kliegman RM,
  • Fanaroff AA. Hypertensive retinopathy in the
  • newborn infant. J Pediatr 1983; 103: 781-786.
There are 99 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Mehmet Helvacı This is me

Özgür İlhan This is me

Hasan Kaya This is me

Mehmet Canda This is me

Publication Date March 3, 2015
Submission Date February 27, 2015
Published in Issue Year 2010 Volume: 1 Issue: 2

Cite

Vancouver Helvacı M, İlhan Ö, Kaya H, Canda M. DESPITE LIMITED BENEFIT, FUNDUSCOPIC EXAMINATION SHOULD BE CONTINUED FOR HYPERTENSION*. mkutfd. 2015;1(2):1-6.