ASSESSMENT OF RETINAL MICROVASCULAR PHYSIOLOGY IN SYSTEMIC HYPERTENSION: INSIGHTS FROM A TERTIARY CARE CENTRE IN NORTH INDIA
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Keywords
Hypertension; Retinal microcirculation; Hypertensive retinopathy; Arteriovenous ratio; Fundus photography; Endothelial dysfunction; Microvascular physiology; North India; Blood pressure; Target organ damage.
Abstract
Background: Systemic hypertension induces widespread microvascular alterations that can be non-invasively visualized in the retina. Retinal microcirculation reflects systemic vascular physiology, and hypertensive retinopathy (HR) serves as a marker of target organ damage. Despite the high prevalence of hypertension in India, data correlating physiological and retinal vascular changes from North Indian tertiary centres remain limited.
Objectives: To evaluate and compare retinal microvascular changes among hypertensive and normotensive individuals and to assess the correlation of retinopathy grades with blood pressure levels, duration of hypertension, and associated systemic factors.
Methods: This hospital-based cross-sectional study included 100 hypertensive patients and 100 age- and sex-matched normotensive controls. Detailed systemic and ocular evaluations were performed. Fundus photographs were graded according to the Keith–Wagener–Barker classification. Statistical analysis included t-test, Chi-square, correlation, and logistic regression using SPSS v26.
Results: Retinal microvascular changes were present in 54% of hypertensives versus 10% of controls (p < 0.001). Grades I and II hypertensive retinopathy accounted for 48% of cases. Systolic blood pressure and duration of hypertension showed significant correlation with retinopathy grade (r = 0.41 and r = 0.38, respectively; p < 0.001). Coexisting diabetes and dyslipidemia were significantly associated with higher grades of retinopathy (p < 0.05). The mean arteriovenous ratio was significantly reduced in hypertensives (0.66 ± 0.06) compared to controls (0.72 ± 0.04).
Conclusion: Retinal microvascular changes are common in hypertensive individuals and closely related to blood pressure severity and duration. The retina serves as a physiological mirror of systemic vascular health, underscoring the importance of regular fundus evaluation in hypertensive management.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Umbreen Nazir
Department of Physiology, Government Medical College, Jammu.
Firdose Kouser
Department of Ophthalmology, Government Medical College, Jammu.
Yassir Mehmood
Department of General Surgery, Government Medical College, Jammu