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January 31, 1966

Prognostic Importance of Ophthalmoscopic Findings in Essential Hypertension

Author Affiliations

From the sections of medicine (Drs. Gifford and Fairbairn) and ophthalmology (Dr. Kearns), Mayo Clinic and Mayo Foundation, and the Mayo Graduate School of Medicine (Dr. Breslin), Rochester, Minn. Dr. Breslin is now in practice in Canton, Ohio and Dr. Gifford is with the Cleveland Clinic.

JAMA. 1966;195(5):335-338. doi:10.1001/jama.1966.03100050043015

Analysis of data on 540 hypertensive patients grouped according to the retinal criteria of Keith, Wagener, and Barker and followed for at least 20 years, or until death, showed that (1) the survival rate in each ophthalmoscopic group was less than that expected in a normal population of the same age and sex distribution, and was poorer for men than for women, (2) there was a definite relationship between severity of retinal changes (ophthalmoscopic grouping) and survival rate and incidence of cardiac and renal complications of hypertension, and (3) for any given level of diastolic blood pressure the prognosis worsened with increase in severity of retinal changes (from lower to higher ophthalmoscopic grouping). It is concluded that changes in the optic fundi remain the simplest, most practical, and most accurate guide to prognosis in hypertension, with or without complications.