Retinopathy in older persons without diabetes and its relationship to hypertension
Retinopathy in older persons without diabetes and its relationship to hypertension
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DOI：
10.1001/archopht.116.1.83
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发表时间：
1998-01-01
影响因子：
--
通讯作者：
Wang, JJ
中科院分区：
文献类型：
--
作者：
Yu, T;Mitchell, P;Wang, JJ
目的：评估非糖尿病老年受试者视网膜病变的患病率及其与全身性高血压的关系。方法：参加蓝山眼科研究的 3654 名 49 岁或以上的受试者接受了详细的眼部检查，包括病史、血压测量和空腹采血。通过立体视网膜照片的遮蔽分级来评估视网膜病变（出血和微动脉瘤）。有糖尿病病史或血糖水平升高的受试者被排除在外。高血压的定义是当前使用抗高血压药物或检查时血压测量值升高。结果：325 名非糖尿病受试者存在视网膜病变，患病率为 9.8%（95% 置信区间 [CI]，8.9%-10.9%），患病率随着年龄的增长而增加。研究发现，患有高血压的女性（RR，1.67；95% CI，1.26-2.21）和男性（RR，1.47；95% CI，1.07-2.00）视网膜病变的年龄调整相对风险（RR）增加。在使用抗高血压药物的人群中，与控制血压相比，未控制的视网膜病变患病率较高，但与高血压持续时间无关。在血压四分位数增加和年龄调整后的视网膜病变患病率之间发现了显着的趋势（P=.02 至 P=.001），这种关系在调整糖尿病的 3 个诊断切点的空腹血糖水平后仍然保持着。结论：这项研究支持 Beaver Dam 眼科研究的发现，即视网膜出血和微动脉瘤是非糖尿病老年人中相对常见的病变，并且与高血压的存在和严重程度显着相关。
Objective: To assess the prevalence and relationship of retinopathy lesions in older subjects without diabetes to systemic hypertension.Methods: Three thousand six hundred fifty-four people aged 49 years or older attending the Blue Mountains Eye Study underwent a detailed eye examination, including medical history, blood pressure measurement, and fasting blood collection. Retinopathy lesions (hemorrhages and microaneurysms) were assessed from masked grading of stereoretinal photographs. Subjects with a history of diabetes or an elevated blood glucose level were excluded. Hypertension was defined as the current use of antihypertensive medications or an elevated blood pressure measurement on examination.Results: Retinopathy was present in 325 subjects without diabetes, a prevalence of 9.8% (95% confidence interval [CI], 8.9%-10.9%), which increased with age. An increased age-adjusted relative risk (RR) for retinopathy was found for women (RR, 1.67; 95% CI, 1.26-2.21) and men (RR, 1.47; 95% CI, 1.07-2.00) with hypertension. In people using antihypertensive medications, retinopathy prevalence was higher for uncontrolled compared with controlled blood pressure but was not related to hypertension duration. Significant (P=.02 to P=.001) trends were found between increasing blood pressure quartiles and age-adjusted retinopathy prevalence, a relationship that was maintained after adjusting for fasting plasma glucose level at 3 diagnostic cut points for diabetes.Conclusions: This study supports the Beaver Dam Eye Study findings that retinal hemorrhages and microaneurysms are relatively frequent lesions in older people without diabetes and are significantly related to the presence and severity of hypertension.