03691nas a2200409 4500008004100000022001400041245007500055210006900130260001300199300001300212490000700225520259400232653000902826653002202835653001902857653001602876653002802892653001902920653002102939653001102960653001102971653003402982653000903016653002403025653001703049653003103066100001603097700001403113700002003127700001503147700001503162700002303177700001703200700001303217700001503230856003603245 1997 eng d a0194-911X00aLeft ventricular mass in the elderly. The Cardiovascular Health Study.0 aLeft ventricular mass in the elderly The Cardiovascular Health S c1997 May a1095-1030 v293 a

Left ventricular (LV) mass, as estimated from M-mode echocardiography (echo), has previously been shown to be an independent predictor of incident cardiovascular disease morbidity and mortality. We evaluated the relationship at baseline of echo LV mass to relevant cardiovascular disease risk factors and other potential covariates in the Cardiovascular Health Study, multicenter study sponsored by the National Heart, Lung, and Blood Institute of 5201 men and women aged 65 years or older (mean, 73). Two-dimensionally directed M-mode echo LV mass measurements could be obtained in 1357 men and 2053 women (66% of this elderly cohort). Stepwise linear regression analyses of the relationship of echo LV mass to demographic and risk factor, physical activity, electrocardiographic, and prevalent disease variables resulted in a model that explained 37% of the variance for the entire cohort. In order of decreasing importance, factors positively associated with echo LV mass were body weight, male sex, systolic pressure, presence of congestive heart failure, present smoking, major and minor electrocardiographic abnormalities, treatment for hypertension, valvular heart disease, aortic regurgitation by color Doppler, and mitral regurgitation by color Doppler (in men) whereas diastolic pressure, bioresistance (a measure of adiposity), and high-density lipoprotein cholesterol were inversely related to echo LV mass. Although height and weight were both related to LV mass, height added nothing once weight was entered in multiple linear regression analyses. Furthermore, in the multiple regression models, diastolic pressure was inversely and systolic BP positively related to LV mass, with similar magnitudes for their coefficients. In consonance with these findings, pulse pressure was positively related to LV mass in bivariate analyses. Multiple linear regression analyses explained less of the variance for ventricular septal thickness (R2 = .13) and LV posterior wall thickness (R2 = .14) than for LV mass (R2 = .37) and LV diastolic dimension (R2 = .27). Intriguing findings in the elderly Cardiovascular Health Study cohort included the presence of pulse pressure as a positive correlate, and high-density lipoprotein cholesterol as an inverse correlate, of LV mass. Longitudinal studies in the Cardiovascular Health Study cohort will help to clarify the importance of demographic, risk factor, and other variables, and changes in these variables, in predicting changes in echo LV mass and its components as well as the prognostic significance of LV mass in the elderly.

10aAged10aAged, 80 and over10aBlood Pressure10aBody Weight10aCardiovascular Diseases10aCohort Studies10aEchocardiography10aFemale10aHumans10aHypertrophy, Left Ventricular10aMale10aProspective Studies10aRisk Factors10aVentricular Function, Left1 aGardin, J M1 aArnold, A1 aGottdiener, J S1 aWong, N, D1 aFried, L P1 aKlopfenstein, H, S1 aO'Leary, D H1 aTracy, R1 aKronmal, R uhttps://chs-nhlbi.org/node/148003202nas a2200397 4500008004100000022001400041245010900055210006900164260001300233300001200246490000700258520214600265653000902411653002202420653001902442653001902461653002502480653000802505653001102513653001102524653000902535653002102544653002402565653001102589653002102600100001502621700001802636700001302654700001702667700001502684700001902699700002002718700001302738700001802751856003502769 2002 eng d a0007-116100aRetinal microvascular abnormalities and blood pressure in older people: the Cardiovascular Health Study.0 aRetinal microvascular abnormalities and blood pressure in older  c2002 Sep a1007-130 v863 a

AIM: To examine the relation between blood pressure and retinal microvascular abnormalities in older people.

METHODS: The Cardiovascular Health Study is a prospective cohort study conducted in four US communities initiated in 1989 to 1990. Blood pressure was measured according to standardised protocols at each examination. During the 1997-8 examination, retinal photographs were taken of 2405 people aged 69-97 years (2056 without diabetes and 349 with diabetes). Signs of focal microvascular abnormalities (focal arteriolar narrowing, arteriovenous nicking, and retinopathy) were evaluated from photographs according to standardised methods. To quantify generalised arteriolar narrowing, the photographs were digitised and diameters of individual arterioles were measured and summarised.

RESULTS: In non-diabetic people, elevated concurrent blood pressure taken at the time of retinal photography was strongly associated with presence of all retinal microvascular lesions. The multivariable adjusted odds ratios, comparing the highest to lowest quintile of concurrent systolic blood pressure, were 4.0 (95% confidence intervals (CI): 2.4 to 6.9, p test of trend<0.001) for focal arteriolar narrowing, 2.9 (95% CI: 1.6 to 5.3, p<0.001) for arteriovenous nicking, 2.8 (95% CI: 1.5 to 5.2, p<0.001) for retinopathy, and 2.1 (95% CI: 1.4 to 3.1, p<0.001) for generalised arteriolar narrowing. Generalised arteriolar narrowing and possibly arteriovenous nicking were also significantly associated with past blood pressure measured up to 8 years before retinal photography, even after adjustment for concurrent blood pressure. These associations were somewhat weaker in people with diabetes.

CONCLUSIONS: Retinal microvascular abnormalities are related to elevated concurrent blood pressure in older people. Additionally, generalised retinal arteriolar narrowing and possibly arteriovenous nicking are related to previously elevated blood pressure, independent of concurrent blood pressure. These data suggest that retinal microvascular changes reflect severity and duration of hypertension.

10aAged10aAged, 80 and over10aBlood Pressure10aCohort Studies10aDiabetic Retinopathy10aEye10aFemale10aHumans10aMale10aMicrocirculation10aProspective Studies10aRetina10aRetinal Diseases1 aWong, T, Y1 aHubbard, L, D1 aKlein, R1 aMarino, E, K1 aKronmal, R1 aSharrett, A, R1 aSiscovick, D, S1 aBurke, G1 aTielsch, J, M uhttps://chs-nhlbi.org/node/699