Hypertension and Your Eyes

According to the CDC, 1 in 3 adults have high blood pressure in the United States.¹ With this systemic disease, there are huge consequences for our bodies, including the eyes.

Blood pressure is the force of blood against your artery walls as it circulates through your body as defined by the CDC.¹ Although our body’s blood pressure naturally rises and falls throughout the day, long term elevated blood pressure can cause damage to the artery walls. This long term damage to arteries can lead to stroke, heart attack or other vasculopathic disorders. Listed below are the guidelines for blood pressure by the American Heart Association.

Blood pressures of 130/80 (either number) and above is considered high and may need treatment.²

Although most people are aware of the harmful effects to the body, most people are unaware of how high blood pressure affects the eyes. When there is damage to the eye from high blood pressure, it is called hypertensive retinopathy. The eye has blood vessels that give nutrients to the retina, which is the tissue at the back of the eye that is used to see the world. Just like your body, high blood pressure forces against the artery walls causes narrowing, which leads to arteriosclerosis or plaque build up inside the artery walls of the retina. The narrowing of the arteries and build up of plaque reduce the oxygen supply to the retina or completely block it off altogether. This reduction or lack of oxygen in the retina can cause bleeding or swelling and can ultimately lead to retinal death and vision loss.

In more advanced cases, the blood supply to the optic nerve can also be reduced or blocked. The optic nerve is responsible for sending the information from what you see in the world to your brain. The reduced blood flow of the optic nerve causes the blood vessels to become leaky, leading to bleeding and swelling of the optic nerve. This can also lead to death of tissue, resulting in reduced vision or in the most severe cases, blindness.

The best way to prevent hypertensive retinopathy is by keeping your body healthy. This means working out and eating healthy. This also means seeing your primary care doctor on a regular basis and following his or her instructions on a healthy lifestyle and taking prescribed medications. It is important to have yearly eye exams with your optometrist or more often if indicated so that hypertensive retinopathy or other ocular conditions can be caught early and treatment initiated to prevent permanent vision loss. Typically, early stages of eye diseases, like hypertensive retinopathy, do not cause visual changes until the condition has progressed to an advanced stage. The earlier we catch hypertensive retinopathy, the better chance we have of saving vision.

Citations:

1. “High Blood Pressure.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 18 July 2018, www.cdc.gov/bloodpressure/
2. “Understanding Blood Pressure Readings.” American Heart Association, Bayer Consumer Health, Nov. 2017, www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings.
3. Mehta, Sonia. “Hypertensive Retinopathy - Eye Disorders.” Merck Manuals Professional Edition, Jan. 2017, www.merckmanuals.com/professional/eye-disorders/retinal-disorders/hypertensive-retinopathy.
4. Vislisel, Jesse, and Toni Venckus. “Normal Fundus - Adult.” Eye Rounds, University of Iowa Healthcare, Jan. 2014, webeye.ophth.uiowa.edu/eyeforum/atlas/pages/normal-fundus.htm.