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/73402879nas a2200337 4500008004100000022001400041245016400055210006900219260001600288300001100304490000700315520187000322653000902192653002802201653002102229653001102250653001102261653001602272653001402288653000902302653003002311653001502341653002402356653002002380100002002400700002102420700002102441700002102462700002302483856003502506 2004 eng d a0735-109700aPrevalence of specific variant carotid geometric patterns and incidence of cardiovascular events in older persons. The Cardiovascular Health Study (CHS E-131).0 aPrevalence of specific variant carotid geometric patterns and in c2004 Jan 21 a187-930 v433 a

OBJECTIVES: We hypothesized that variant geometric patterns of the common carotid artery (CCA) predict the incidence of cardiovascular disease (CVD), after accounting for CCA intima-medial thickness (IMT).

BACKGROUND: Common carotid artery intima-media thickness has been associated with the incidence of cardiovascular disease.

METHOD: Noninvasive measurements of IMT were made with high-resolution ultrasonography in 5,640 subjects 65 years of age or older participating in the Cardiovascular Health Study. New coronary and/or cerebrovascular events served as outcome variables over a median 10.2-year follow-up. To characterize different carotid structural geometric patterns (CGP), vascular mass (VM) was combined with the wall-to-lumen ratio (W/L). Normal values for W/L and VM were defined as age-adjusted, gender-specific 75th percentiles of the 1,899 normotensive subjects free of CVD at baseline. Four CGPs were defined: CGP1 = normal W/L ratio and VM; CGP2 = arterial remodeling (i.e., increased W/L ratio with normal VM); CGP3 = arterial hypertrophy (i.e., increased W/L ratio with increased VM); and CGP4 = arterial hypertrophy with dilation (i.e., normal W/L ratio and increased VM).

RESULTS: Coronary or cerebrovascular events (adjusted for age, gender, traditional risk factors, and IMT) were associated with CGP in subjects free of CVD at baseline. Specifically, the hazard ratio (Cox proportional-hazards analyses) for CGP3 (arterial hypertrophy) was 1.25 (95% confidence interval [CI] 1.03 to 1.53), and for CGP4 (arterial hypertrophy with dilation) was 1.43 (95% CI 1.16 to 1.75) compared with CGP1 (normal).

CONCLUSIONS: Arterial hypertrophy defined by variant CGP patterns is associated with the development of new CVD, independent of age, traditional risk factors, and CCA IMT.

10aAged10aCardiovascular Diseases10aCarotid Arteries10aFemale10aHumans10aHypertrophy10aIncidence10aMale10aPredictive Value of Tests10aPrevalence10aProspective Studies10aUltrasonography1 aScuteri, Angelo1 aManolio, Teri, A1 aMarino, Emily, K1 aArnold, Alice, M1 aLakatta, Edward, G uhttps://chs-nhlbi.org/node/764