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Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs
  1. Lap-kin Chiang1,
  2. Michael K.C. Yau1,
  3. Cheuk-wai Kam1,
  4. Lorna V. Ng1 and
  5. Benny C.Y. Zee2
  1. 1.Family Medicine and General Outpatient Department, Kwong Wah Hospital, Hospital Authority, Hong Kong, China
  2. 2.The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  1. Corresponding author: Lap-kin Chiang, MBChB (CUHK), MSc (CUHK), MFM (Monash), Family Medicine and General Outpatient Department, Kwong Wah Hospital, 1/F, Tsui Tsin Tong Outpatient Building, Kwong Wah Hospital, 25 Waterloo Road, Mongkok, Hong Kong, China, E-mail: chialk{at}


Objective The objective is to estimate the prevalence and grading of hypertensive retinopathy in the primary care setting; examine the patient characteristics associated with hypertensive retinopathy; and examine the association of hypertensive retinopathy and other hypertension complications.

Methods This is a retrospective cross-sectional study. Subjects included adult hypertensive patients with available and gradable retinal photographs.

Results Two hundred fifty-six male hypertensive patients (34.3%) and 491 female hypertensive patients (65.7%) were included. The average duration of hypertension was 7.2 years, and 49.8% and 41.2% of patients were taking one or two antihypertensive medications respectively. Among 1491 qualified retinal photographs (744 right eye and 747 left eye), 24.9%, 62.6%, and 12.5% were classified as showing normal, mild, and moderate hypertensive retinopathy respectively. The three commonest retinal signs were generalized or focal arteriolar narrowing (650 cases, 43.6%), hard exudates (168 cases, 11.3%), and opacity (copper or silver wiring) of the arteriolar wall (166 cases, 11.1%). Patients older than 61 years, having hypertension for more than 15 years, or taking three or more antihypertensive medications were significantly associated with hypertensive retinopathy (P<0.05).

Conclusion In a primary care clinic in Hong Kong, 77.1% of hypertensive patients had hypertensive retinopathy. Advanced hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.

  • Hypertensive retinopathy
  • retinal photograph
  • primary care

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