03786nas a2200445 4500008004100000022001400041245012600055210006900181260001300250300001100263490000800274520252700282653000902809653002202818653001902840653002802859653002802887653001102915653001102926653001702937653000902954653001502963653002102978653002002999653001703019653001803036100002003054700001803074700002103092700002103113700002203134700002103156700001803177700001903195700002203214700002103236700002403257700002403281856003503305 2003 eng d a0161-642000aThe prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study.0 aprevalence and risk factors of retinal microvascular abnormaliti c2003 Apr a658-660 v1103 a

PURPOSE: To describe the prevalence of retinal microvascular characteristics and their associations with atherosclerosis in elderly, nondiabetic persons.

DESIGN AND PARTICIPANTS: Population-based, cross-sectional study comprising 2050 men and women aged 69 to 97 years without diabetes, living in four communities.

METHODS: Participants underwent retinal photography and standardized grading of retinal microvascular characteristics, including retinopathy (e.g., microaneurysms, retinal hemorrhages), focal arteriolar narrowing, and arteriovenous nicking. In addition, calibers of retinal arterioles and venules were measured on digitized photographs to obtain an estimate of generalized arteriolar narrowing. Atherosclerosis and its risk factors were obtained from clinical examination and laboratory investigations.

MAIN OUTCOME MEASURES: Prevalence of retinal microvascular abnormalities and their associations with measures of atherosclerosis.

RESULTS: The prevalence of retinal microvascular abnormalities was 8.3% for retinopathy, 9.6% for focal arteriolar narrowing, and 7.7% for arteriovenous nicking. All retinal lesions were associated with hypertension (odds ratios [OR] were 1.8 for retinopathy, 2.1 for focal arteriolar narrowing, 1.5 for arteriovenous nicking, and 1.7 for generalized arteriolar narrowing). After controlling for age, gender, race, mean arterial blood pressure, and antihypertensive medication use, retinopathy was associated with prevalent coronary heart disease (OR, 1.7), prevalent myocardial infarction (OR, 1.7), prevalent stroke (OR, 2.0), presence of carotid artery plaque (OR, 1.9), and increased intima-media thickness of the common carotid (OR, 2.3; fourth vs. first quartile) and internal carotid (OR, 1.8; fourth vs. first quartile) arteries. In contrast, focal arteriolar narrowing, arteriovenous nicking, and generalized arteriolar narrowing were not associated with any measures of atherosclerosis.

CONCLUSIONS: Retinal microvascular abnormalities are common in older persons without diabetes and are related to hypertension. Retinopathy is associated with prevalent coronary heart disease, stroke, and carotid artery thickening, but focal and generalized arteriolar narrowing and arteriovenous nicking are not related to most measures of atherosclerosis. These data suggest that retinal microvascular abnormalities reflect processes associated with hypertension but distinct from atherosclerosis.

10aAged10aAged, 80 and over10aBlood Pressure10aCoronary Artery Disease10aCross-Sectional Studies10aFemale10aHumans10aHypertension10aMale10aPrevalence10aRetinal Diseases10aRetinal Vessels10aRisk Factors10aUnited States1 aWong, Tien, Yin1 aKlein, Ronald1 aSharrett, Richey1 aManolio, Teri, A1 aHubbard, Larry, D1 aMarino, Emily, K1 aKuller, Lewis1 aBurke, Gregory1 aTracy, Russell, P1 aPolak, Joseph, F1 aGottdiener, John, S1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/734