Omotoso A B, Kolo P M, Olanrewaju T O, Owoeye J F, Biliaminu S A, Olatunji V A
Department of Medicine, University of Ilorin, P.M.B. 1515, Ilorin, Nigeria.
Department of Ophthalmology, University of Ilorin, P.M.B. 1515, Ilorin, Nigeria.
Clin Hypertens. 2016 Oct 21;22:19. doi: 10.1186/s40885-016-0053-x. eCollection 2016.
Complications of hypertension are particularly common in people of African descent but previous reports had suggested rarity of hypertensive retinopathy in black Africans. We evaluated retinal changes among Nigerian hypertensive patients and determined their relationship with renal function.
Consecutive Hypertensive patients who were ≥18 years were selected for the study. Socio-demographic characteristics, anthropometric parameters and blood pressure were measured. All patients had ophthalmoscopic examination and retinal changes were graded according to Keith-Wegener's classification. Blood samples were taken for blood urea nitrogen, lipids and C-reactive protein; and urine was collected for creatinine and microalbuminuria. Serum creatinine was determined using modified Jaffe method and estimated glomerular filtration (eGFR) was calculated using MDRD equation: 186 × (Creatinine/88.4) × (Age) × (0.742 if female) × (1.210 if black).
Of the 240 patients studied, 187 (78 %) had one form of retinopathy or the other. While 85 (35.4 %) patients had grade 1 retinopathy, 87 (36.3 %) had grade 2, 13 (5.4 %) had grade 3 and 2 (0.83 %) had grade 4 respectively. Comparison of patients with and without retinopathy showed that, the former were older ( = 0.001) and had longer duration of hypertension ( = 0.001). Similarly, hypertensive patients with retinopathy had higher total cholesterol and low density lipoprotein cholesterol ( = 0.017, = 0.041 respectively). However, eGFR was lower in individuals with retinopathy (46.2 ml/min/1.73) than those with normal retinal (55.9 ml/min/1.73) findings, = 0.019. Multi-variable adjusted odds ratios showed increased probability of retinopathy with age (odds ratio-1.08, = 0.001) and body mass index (odds ratio-1.20, = 0.013).
Hypertensive retinopathy is a common clinical finding among hypertensive Nigerians and may occur with renal damage as consequences of long standing hypertension.
高血压并发症在非洲裔人群中尤为常见，但先前的报告表明，非洲黑人高血压性视网膜病变较为罕见。我们评估了尼日利亚高血压患者的视网膜变化，并确定了它们与肾功能的关系。
选择年龄≥18岁的连续性高血压患者进行研究。测量社会人口学特征、人体测量参数和血压。所有患者均接受眼底镜检查，并根据Keith-Wegener分类法对视网膜变化进行分级。采集血样检测血尿素氮、血脂和C反应蛋白；收集尿液检测肌酐和微量白蛋白尿。采用改良Jaffe法测定血清肌酐，并使用MDRD方程计算估算肾小球滤过率（eGFR）：186×（肌酐/88.4）×年龄×（女性为0.742）×（黑人男性为1.210）。
在研究的240例患者中，187例（78%）患有某种形式的视网膜病变。其中，85例（35.4%）患者为1级视网膜病变，87例（36.3%）为2级，13例（5.4%）为3级，2例（0.83%）为4级。有视网膜病变和无视网膜病变患者的比较显示，前者年龄更大（P=0.001），高血压病程更长（P=0.001）。同样，有视网膜病变的高血压患者总胆固醇和低密度脂蛋白胆固醇水平更高（分别为P=0.017，P=0.041）。然而，有视网膜病变者的eGFR（46.2ml/min/1.73）低于视网膜正常者（55.9ml/min/1.73），P=0.019。多变量调整后的比值比显示，随着年龄（比值比-1.08，P=0.001）和体重指数（比值比-1.20，P=0.013）的增加，视网膜病变的发生概率增加。
高血压性视网膜病变是尼日利亚高血压患者常见的临床发现，可能是长期高血压导致肾脏损害的结果。
