Document Detail


Value of retinal examination in hypertensive encephalopathy.
MedLine Citation:
PMID:  19865107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The presence of grade III or IV hypertensive retinopathy (HRP) is considered to distinguish hypertensive urgencies from emergencies. However, case-reports suggest that these retinal changes may be lacking in patients with hypertensive encephalopathy. To assess the frequency of grade III and IV retinopathy in this hypertensive emergency, we conducted a retrospective cohort study. We retrieved 162 patients with malignant hypertension and 34 patients (17%) fulfilled the predefined criteria for hypertensive encephalopathy. Data on retinal examination were incomplete for 6 patients (18%), thus leaving 28 patients who were analysed for the presence or absence of grade III and IV HRP. In 9 (32%) patients with hypertensive encephalopathy, grade III or IV HRP was absent, 11 (39%) patients presented with grade III and 8 (29%) patients with grade IV retinopathy. Patients without retinal abnormalities were on average 13 years younger (P=0.05), more often black (P=0.02) and displayed lower blood pressure (BP) values (P=0.04 for systolic and diastolic BP). A substantial proportion of patients with hypertensive encephalopathy lack grade III or IV HRP. This suggests that the decision to admit these patients should not only rely on the presence of grade III and IV retinopathy alone, but should also include a careful neurological examination.
Authors:
F Amraoui; G A van Montfrans; B J H van den Born
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Publication Detail:
Type:  Journal Article     Date:  2009-10-29
Journal Detail:
Title:  Journal of human hypertension     Volume:  24     ISSN:  1476-5527     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-18     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  274-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Diagnosis, Differential
Female
Humans
Hypertension, Malignant / diagnosis*,  epidemiology
Hypertensive Encephalopathy / diagnosis*,  epidemiology
Male
Middle Aged
Ophthalmoscopy*
Retinal Diseases / diagnosis*,  epidemiology
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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