Hypertensive Retinopathy

Hypertensive retinopathy is a condition in which people with high blood pressure show a variety of retinal vascular signs, including hemorrhages, microaneurysms, hard exudates, cotton wool spots, and retinal arteriolar narrowing. Signs of hypertensive retinopathy are common, even in people without hypertension. Signs of hypertensive retinopathy among people without hypertension are suggestive of the ability of these signs to predict future hypertension. Signs of hypertensive retinopathy also are reliably associated with current high blood pressure. Further, retinal arteriolar narrowing is related not only to past and current blood pressure, but also to future blood pressure. Stated differently, retinal arteriolar narrowing has been shown to be an independent predictor of systemic vascular disease. Specifically, it has been associated with cerebrovascular disease (eg, clinical diagnosis of stroke, MRI diagnosis of stroke) and cardiovascular disease such as heart failure. Because of its ability to predict both future hypertension as well as future clinical outcomes, hypertensive retinopathy screening may be a viable strategy for the prevention of macrovascular events.