PubMed ID: 36936860
Author(s): Liew G, Xie J, Nguyen H, Keay L, Kamran Ikram M, McGeechan K, Klein BE, Jin Wang J, Mitchell P, Klaver CC, Lamoureux EL, Wong TY. Hypertensive retinopathy and cardiovascular disease risk: 6 population-based cohorts meta-analysis. Int J Cardiol Cardiovasc Risk Prev. 2023 Mar 5;17:200180. doi: 10.1016/j.ijcrp.2023.200180. eCollection 2023 Jun. PMID 36936860
Journal: International Journal Of Cardiology. Cardiovascular Risk And Prevention, Volume 17, Jun 2023
BACKGROUND The cardiovascular risk associated with different levels of hypertensive retinopathy, including mild, remains unclear. We performed an individual participant meta-analysis from 6 population-based cohort studies to determine the relationship of hypertensive retinopathy with incident cardiovascular outcomes.
METHODS We identified cohort studies that objectively assessed hypertensive retinopathy from photographs, documented incident cardiovascular outcomes, and were population-based. Six studies contributed data from 11,013 individuals at baseline with 5-13 years follow-up. Participants were recruited if they had hypertension and did not have confounding conditions such as diabetic retinopathy. Main outcome measures were incident coronary heart disease (CHD), stroke and a composite endpoint of cardiovascular disease (CHD or stroke). Pooled estimates of incident risk ratios (IRR) were obtained after adjusting for age, gender, systolic blood pressure, serum total cholesterol, high density lipoprotein and smoking.
RESULTS Among eligible participants with hypertension and without diabetes, there were 1018/9662 (10.5%) incident CHD events, 708/11,013 (6.4%) incident stroke events and 1317/9378 (14.0%) incident CVD events. Mild hypertensive retinopathy was associated with increased risk of CVD (IRR 1.13, 95% CI 1.00 to 1.27) and CHD (IRR 1.17, 95% CI 1.02 to 1.34) but not stroke; moderate hypertensive retinopathy was associated with increased risk of CVD (IRR 1.25 95% CI 1.02 to 1.53) but not stroke or CHD individually.
CONCLUSIONS In persons with hypertension, both mild and moderate hypertensive retinopathy were associated with higher CVD risk.
© 2023 The Authors. Published by Elsevier B.V.