Determinants of hypertensive retinopathy among non-diabetic adults in comprehensive specialized hospitals of the Amhara region, northwest Ethiopia: a case-control study.

BACKGROUND

Hypertensive retinopathy is a common microvascular complication of hypertension associated with visual impairment and increased cardiovascular risk, but evidence regarding its associated factors in Ethiopia is limited. This study aimed to identify factors associated with hypertensive retinopathy among adult hypertensive patients in northwest Ethiopia.

METHODS

An institution-based unmatched case-control study was conducted from 4 June to 30 June 2024, among 309 participants (76 cases and 233 controls). Cases were hypertensive patients with retinopathy diagnosed by ophthalmologists, while controls were hypertensive patients without retinopathy. Systematic random sampling was used to select study participants. The primary outcome measure was the presence of hypertensive retinopathy (yes/no), as diagnosed and documented in medical records. Data were collected through interviewer-administered questionnaires, medical record reviews, and physical measurements (blood pressure, weight, and height). Self-care and social support were assessed using validated scales. Multivariable logistic regression identified factors associated with retinopathy, and model fit was assessed by the Hosmer-Lemeshow test (P > 0.05). Significance was set at P < 0.05.

RESULTS

The mean age of study participants was 51.75 ± 8.84 years. Factors associated with hypertensive retinopathy included: urban residence (AOR = 10.6; 95% CI: 2.9-37.9), BMI ≥25 kg/m2 (AOR = 7.9; 95% CI: 2.6-24.2), diastolic BP > 90 mmHg (AOR = 25.3; 95% CI: 3.1-212.1), poor self-care (AOR = 5.6; 95% CI: 2.1-15.9), and lack of social support (AOR = 5.1; 95% CI: 2.1-12.4).

CONCLUSION

Urban residence, elevated BMI, uncontrolled diastolic blood pressure, poor self-care, and lack of social support independently increase the odds of hypertensive retinopathy. Comprehensive management that integrates retinal screening, self-care education, and social support is needed, especially in urban areas.