Title : Hypertensive retinopathy can predict severity of coronary artery disease in hypertensive patients presenting with angina
Hypertension injures blood vessels, which may be macro vascular like coronary artery or micro vascular like retinal artery. Retina is the only place in the body where micro vascular damage can be observed directly. Retinal microvascular changes a suitable window to detect changes related to the pathophysiological changes that occurred in coronary artery disease and hypertension.
Objective: Assess the relationship between retinal micro vascular changes and angiographic findings in hypertensive patients presenting with angina.
Methods: A prospective study was done over one year including 80 hypertensive patients with positive and or equivocal stress test for angina diagnosis were referred to ophthalmology to assess severity of retinal atherosclerosis by Scheie classification after that severity and extent of coronaries lesions assessed by coronary angiography using Gensini and modified Gensini score.
Results: 80 patients (53 males and 27 females) age range (38-76 years) with mean of 53.3 ± 7.97, 31. There was a significant correlation between the occurrences of retinal artery atherosclerosis and severity of coronary artery disease (CAD) development p=0.0001. Also CAD severity (using modified Gensini scoring) as a dependent variable a significant association between it and retinal atherosclerosis scores by Scheie criteria, and hypertension, smoking, and left ventricular hypertrophy.
Conclusions: Retinal hypertensive changes at any grade can predict CAD severity in any hypertensive patients presenting with anginal chest pain with a moderate to high accuracy. Therefore retinopathy has a predictive and good association with CAD in patients with hypertension.