The Keith-Wagener-Barker and Mitchell-Wong grading systems for hypertensive retinopathy: association with target organ damage in individuals below 55 years

Journal of Hypertension
Evaggelia K AissopouAthanasios D Protogerou

Abstract

The usefulness of the hypertensive retinopathy classification by Keith-Wagener-Barker (KWB) in clinical practice remains controversial. The simplified Mitchell-Wong grading, combining the two initial KWB' grades in one stage, is proposed as an alternative method; both systems are poorly validated regarding their association with target organ damage. In a population free of cardiovascular disease and diabetes, we aimed to investigate the interobserver and intraobserver agreement of both grading systems, their association with aortic stiffness, carotid hypertrophy or plaques and the role of age and sex on this association. Digital retinal images were obtained and graded - according to both classifications - by two independent and blinded observers; aortic stiffness (carotid-femoral pulse wave velocity, m/s) and common carotid hypertrophy (cross-sectional area, mm) or plaques were assessed by tonometry and ultrasound, respectively. From the gradable retinal photos obtained by 200 eyes of 107 consecutive patients (age: 54 ± 13 years, 51% men, 79% hypertensive patients) and after adjustments for confounders, the intraobserver and interobserver level of agreement was as following: KWB 88/64% and Mitchell-Wong 91/71%, respectively; ex...Continue Reading

References

May 20, 1989·BMJ : British Medical Journal·R D LangerE Barrett-Connor
May 20, 1989·Lancet·S B DimmittW A Littler
Dec 1, 1974·The American Journal of the Medical Sciences·N M KeithN W Barker
Oct 1, 1982·Ophthalmology·M O Tso, L M Jampol
Sep 1, 1996·Journal of the American College of Cardiology·M J RomanR B Devereux
Jul 1, 1999·Current Opinion in Ophthalmology·H D Schubert
Jun 10, 2000·Arteriosclerosis, Thrombosis, and Vascular Biology·R KleinG Evans
Mar 7, 2002·JAMA : the Journal of the American Medical Association·Tien Yin WongLarry D Hubbard
Aug 20, 2002·The British Journal of Ophthalmology·B B DuncanF D Fuchs
Nov 7, 2002·Journal of Human Hypertension·S ChatterjeeS Chattopadhya
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Jun 30, 2004·Investigative Ophthalmology & Visual Science·M Kamran IkramPaulus T V M de Jong
Sep 2, 2004·Journal of the American Society of Nephrology : JASN·Tien Yin WongBruce B Duncan
Oct 14, 2004·Journal of Hypertension·Cesare CuspidiAlberto Zanchetti
Nov 27, 2004·The New England Journal of Medicine·Tien Y Wong, Paul Mitchell
Jul 9, 2005·BMJ : British Medical Journal·Bert-Jan H van den BornGert A van Montfrans
Sep 27, 2006·European Heart Journal·Stephane LaurentUNKNOWN European Network for Non-invasive Investigation of Large Arteries
May 20, 2009·Therapeutic Advances in Cardiovascular Disease·Cesare CuspidiCarla Sala
Mar 27, 2010·Journal of the American College of Cardiology·Charalambos VlachopoulosChristodoulos Stefanadis
Jun 5, 2010·Stroke; a Journal of Cerebral Circulation·Hiroshi YatsuyaUNKNOWN ARIC Study Investigators
Oct 30, 2010·Clinical and Experimental Hypertension : CHE·Gee-Hee KimJung-Il Moon
Jan 25, 2011·International Journal of Cardiology·Vasiliki KatsiIoannis Kallikazaros
Aug 19, 2011·Neurology·D A De SilvaUNKNOWN Multi-Centre Retinal Stroke Study Group
Mar 2, 2013·Journal of Hypertension·Laura E DownieTien Y Wong

❮ Previous
Next ❯

Citations

Dec 19, 2016·Clinical & Experimental Ophthalmology·Samantha Fraser-BellAnagha Vaze
Oct 18, 2016·Current Opinion in Ophthalmology·Lazaros Konstantinidis, Yan Guex-Crosier
Jun 3, 2020·Ophthalmic Surgery, Lasers & Imaging Retina·Bradley H JacobsenAkbar Shakoor
Jul 30, 2020·Investigative Ophthalmology & Visual Science·Qingsheng PengXiaohong Yang
Dec 21, 2019·Clinical and Experimental Hypertension : CHE·Timuçin YıldırımBunyamin Yavuz
Feb 14, 2021·Journal of Pediatric Endocrinology & Metabolism : JPEM·Duygu DeligözoğluÖnder Yavaşcan
Dec 15, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Yinhe LiuZipei Jiang
Jan 9, 2018·The American Journal of Pathology·Shu-Huai TsaiLih Kuo

❮ Previous
Next ❯

Software Mentioned

SPSS

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Cardiovascular Disorder in Diabetes

Diabetes is associated with an increased risk of cardiovascular disorders and heart failure. Discover the latest research here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.