Retinal imaging to identify target organ damage in older Africans: A pilot study

By 2030, sub‐Saharan Africa is forecast to see the steepest rise in the number of people with hypertension of any world region. Hypertensive retinopathy is known to be a common complication of hypertension in developed countries and some studies suggest it is associated with the presence of other hypertension‐related end‐organ damage ( EOD ) such as stroke and cardiovascular disease. In Tanzania hypertension is relatively more common than in other parts of sub‐Saharan Africa , especially in the older population; however, the prevalence of hypertensive retinopathy and its association with EOD remain unknown. The authors conducted a cross‐sectional study of elderly, community‐dwelling, rural Tanzanians to determine the prevalence of hypertensive retinopathy and its association with hypertension and other forms of EOD . Hypertensive retinopathy was diagnosed based on retinal imaging. In a cohort of 61 patients with gradable images, the authors found the overall prevalence of hypertensive retinopathy to be 64% (n = 39), which was strongly associated with hypertension ( X 2 [1] = 4.207, P  = .004), with a significant trend towards more severe retinopathy with more severe hypertension ( r  = .377, P  = .003). The authors did not find hypertensive retinopathy to be associated with other forms of EOD . Hypertensive retinopathy is highly prevalent in this population and is associated in most but not all cases with hypertension. These findings do not suggest that it could be used as a screening tool for EOD, but it is important to identify and educate patients with retinopathy about possible complications of the condition.