Blood Pressure Threshold for Abnormal Ocular Fundus Findings is Lower than Expected

• Authors: Beau Benjamin Bruce, Emory University; Cedric Lamirel, Emory University; David W Wright, Emory University; Valerie Biousse, Emory University; Nancy J Newman, Emory University
• Journal Title: Hypertension
• Volume: Volume 59, Number 2
• Publisher: American Heart Association | 2012-02, Pages e8-e9
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1161/HYPERTENSIONAHA.111.187781
• Subjects: Health Sciences, Medicine and Surgery; Health Sciences, Opthamology

Abstract

Ocular fundus examination is a critical part of the physical examination in patients with severely elevated blood pressure (BP), which is defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) as a BP exceeding 180/120 mm Hg. Indeed, the presence or absence of severe, grade III/IV hypertensive retinopathy helps differentiate hypertensive emergencies requiring intensive care from less severe hypertensive urgencies. As a secondary analysis in the Fundus photography versus Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study, we sought to explore potential risk factors, in particular BP, for the presence of ocular fundus abnormalities relevant to the care of emergency department (ED) patients. We found evidence of acute end-organ ocular damage at lower blood pressures than the JNC7 criteria.