February brings on thoughts of candy, love and hearts. Your heart and its ability to function is major concern of mine when doing routine eye examinations. Globally 46% of adults over the age of 25 have high blood pressure and 20% are completely unaware. Hypertension is a chronic condition which requires proper management to ensure a long healthy life.
Poorly controlled or undiagnosed hypertensives can easily acquire target organ damage leading to Hypertensive Crisis, renal failure, heart failure and stroke. At least 2% of patients with high blood pressure experience hypertensive crisis at some point in their lives. Examination of the retinal blood vessels is a good way to monitor for subtle changes that put you at risk for hypertensive crisis.
Early Hypertensive Retinopathy begins with narrowing of the retinal arterioles, or small vessels in the back of your eye. This is the first sign that your body’s ability to autoregulate your own blood pressure is under stress. At this stage patients often have no symptoms. You feel fine. Your blood pressure may be mildly elevated or you may be on low dose of blood pressure medication.
The next stage becomes more serious. Here there is further break down of the blood vessels. In the retina I will see small hemorrhages or loss of fluid from the vessels. Think of it as a hose springing a leak because you have applied to much pressure to it. This is the stage you are likely to acquire target organ damage. The Atherosclerosis Risk in Communities Study which has been on going since 1987 states patients presenting with Moderate Hypertensive Retinopathy are significantly more likely to have a stroke within the next three years. Proper antihypertensive treatment can reduce your risk by 90%. Common patient symptoms may include headache and frequent nose bleeds.
The final stage of hypertension is the complete loss of your body’s ability to autoregulate your blood pressure. This leads to sever oxygen starvation to your retina, brain and other major organs. This is also known as Hypertensive Crisis. Patients often have symptoms of chest pain, shortness of breath and or headache. People with these symptoms should report to the Emergency Room immediately for proper treatment. Without proper treatment these patients have a less than 1% survival rate at one year.
So when you get that heart shaped box of candy this February think about the last time you had your blood pressure properly checked and the last time you had your eyes examined.
Dr. Cameron owns and operates Cameron Optical located in Montgomery, Texas. See our ad in this issue for further details.