A 2007 meta-analysis found that vaccinations were associated with a halving of the risk of SIDS, and argued that immunisation should be a part of SIDS prevention campaigns. Epidemiology
Globally, SIDS resulted in about 22,000 deaths as of 2010, down from 30,000 deaths in 1990. Rates vary significantly by population from 0.05 per 1000 in Hong Kong to 6.7 per 1000 in Native Americans.SIDS was responsible for 0.54 deaths per 1,000 live births in the US in 2005. It is responsible for far fewer deaths than congenital disorders and disorders related to short gestation, though it is the leading cause of death in healthy infants after one month of age. SIDS deaths in the US decreased from 4,895 in 1992 to 2,247 in 2004, a 54% decrease. During a similar time period, 1989 to 2004, SIDS as the cause of death for sudden infant death (SID) decreased from 80% to 55%, a 31% decrease. According to John Kattwinkel, chairman of the Centers for Disease Control and Prevention (CDC) Special Task Force on SIDS "A lot of us are concerned that the rate (of SIDS) isnt decreasing significantly, but that a lot of it is just code shifting". Race
In 2013, there were persistent disparities in SIDS deaths among racial and ethnic groups in the U.S. In 2009, the rates of death range from 20.3 per 100,000 live births for Asian/Pacific Islander to 119.2 per 100,000 live births for Native Americans/Alaska Native.
Pathophysiology
The changes in hypertensive retinopathy result from damage and adaptive changes in the arterial and arteriolar circulation in response to the high blood pressure. Diagnosis
Fundoscopy and patients history. Differential Diagnoses
Several other diseases can result in retinopathy that can be confused with hypertensive retinopathy. These include diabetic retinopathy, retinopathy due to autoimmune disease, anemia, radiation retinopathy, and central retinal vein occlusion. Keith Wagener Barker (KWB) Grades
Grade 1
Vascular Attenuation
Grade 2
As grade 1 + Irregularly located, tight constrictions – Known as "AV nicking" or "AV nipping" – Saluss sign
Grade 3
As grade 2 + Retinal edema, cotton wool spots and flame-hemorrhages "Copper Wiring" + Bonnets Sign + Gunns Sign
Grade 4
As grade 3 + optic disc edema + macular star "Silver Wiring"There is an association between the grade of retinopathy and mortality. In a classic study in 1939 Keith and colleagues described the prognosis of people with differing severity of retinopathy. They showed 70% of those with grade 1 retinopathy were alive after 3 years whereas only 6% of those with grade 4 survived. The most widely used modern classification system bears their name. The role of retinopathy grading in risk stratification is debated, but it has been proposed that  individuals with signs of hypertensive retinopathy signs, especially retinal hemorrhages, microaneurysms and cotton-wool spots, should be assessed carefully. Management
A major aim of treatment is to prevent, limit, or reverse target organ damage by lowering the persons high blood pressure to reduce the risk of cardiovascular disease and death.