Department of Neurology, Kyunghee University East-West Neo Medical Center, Seoul, Republic of Korea.
BACKGROUND AND PURPOSE:
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).
CONCLUSION:
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.
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