| Studies on the Vascular Sclerosis in Hypertensive Disease. |
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Sang Wook Lee |
1Department of Ophthalmology, Catholic Medical College, Seoul, Korea.
2Department of Ophthalmology, School of Medicine, Seoul National University, Seoul, Korea. |
| 고혈압증 (高血壓症) 환자의 (患者) 동맥경화에 (動脈硬化) 관한 (關) 연구 (硏究) |
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이상욱(Sang Wook Lee) |
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| Abstract |
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The author investigated 100 hypertensive patients (199 eyes) on their brachial blood pressure, ophthalmic blood pressure, Fritz's index, sclerotic changes in retinal vessels, and P.S.P. test. The vascular changes of the retina were classified according to the Keith-Wagener scheme, and the sclerotic changes were represented by the point system. For the evaluation of circulatory status of the carotid system, r(s)/r(d)-carotis ratio and cerebrovascular resistance (CVR) were also calculated. The relationships between these data were studied and their results were as follows: (1) There was a linear correlation between mean ophthalmic blood pressure and mean brachial blood pressure, the correlation coefficient being plus 0.83. (2) There was also a linear relationship between fundus changes and mean ophthalmic blood pressure. The more advanced the grade of Keith-Wagener classification and the sclerotic changes, the higher the mean ophthalmic blood pressure. The rise of the mean ophthalmic blood pressure as more marked in K-W grade III, IV, and in grade IV sclerosis. (3) There was a close relationship between P.S.P. test, mean ophthalmic blood pressure and brachial blood pressure. The renal function was disturbed in patients with higher mean ophthalmic blood pressure. (4) The decrease of r(s)/r(d) carotis was always accompanied by the increase of Fritz's index, severity of sclerotic changes in the retina and advancement of the grade of K-W classification. (5) In patients with normal P.S.P. value, there was no single case of advanced sclerosis (more than 10 points of sclerosis). r(s)/r(d) carotis ratio was generally over 1.0. In patients with low P.S.P. value, however, the retinal vascular sclerosis shoshowed more marked changes, and r(s)/r(d) carotis ratio failed below 1.0. (6) Generally, there was a tendency of the increase in the CVR in accordance with the increase in Fritz's index and sclerotic changes. Moreover, functional disturbance of the kidney was usually associated with higher CVR. (7) The author proposed the possibilities that CVR value more than 0.5 or r(s)/r(d)-carotis ratio below 1.0 might represent the advanced sign of vascular sclerosis, disturbance of kidney function. |
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