TY - JOUR T1 - Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study. JF - Arch Intern Med Y1 - 2006 A1 - Wong, Tien Yin A1 - Kamineni, Aruna A1 - Klein, Ronald A1 - Sharrett, A Richey A1 - Klein, Barbara E A1 - Siscovick, David S A1 - Cushman, Mary A1 - Duncan, Bruce B KW - Aged KW - Aged, 80 and over KW - Algorithms KW - Cardiovascular Diseases KW - Cohort Studies KW - Female KW - Humans KW - Image Processing, Computer-Assisted KW - Incidence KW - Male KW - Photography KW - Prospective Studies KW - Retinal Diseases KW - Retinal Vein KW - Retinal Vessels KW - Risk Factors KW - Stroke KW - United States AB -

BACKGROUND: Small vessel disease may contribute to the risk of cardiovascular disease in older persons. We describe the relation of retinal vascular caliber to incident coronary heart disease (CHD) and stroke in elderly persons.

METHODS: Prospective population-based cohort study composed of 1992 men and women aged 69 to 97 years living in 4 US communities. Retinal arteriolar and venular calibers were measured from retinal photographs using a computer-assisted method. Incident CHD and stroke events were ascertained using standardized methods.

RESULTS: After 5 years of follow-up, there were 115 incident CHD events and 113 incident stroke events. Participants with larger retinal venular caliber had a higher incidence of CHD (11.7%; 95% confidence interval [CI], 8.7%-15.8%, vs 8.1%; 95% CI, 5.7%-11.6%), comparing largest with smallest venular caliber quartiles, and stroke (8.4%; 95% CI, 6.0-11.7, vs 5.8%; 95% CI, 3.9-8.4). At multivariable analysis, controlling for age, sex, race, arteriolar caliber, systolic and diastolic blood pressure, diabetes, glucose concentration, cigarette smoking, pack-years of smoking, and high-density-lipoprotein and low-density lipoprotein cholesterol levels, larger retinal venular caliber was associated with incident CHD (rate ratio, 3.0; 95% CI, 1.6-5.7, comparing largest with smallest venular caliber quartiles; P(trend) = .001) and incident stroke (rate ratio, 2.2; 95% CI, 1.1-4.3; P(trend) = .02). Additional adjustment for C-reactive protein and common and internal carotid artery intimal-media thickness had minimal effect on these associations. At multivariable analysis, smaller retinal arteriolar caliber was associated with incident CHD (rate ratio, 2.0; 95% CI, 1.1-3.7, comparing largest with smallest arteriolar caliber quartiles; P = .03) but not stroke (rate ratio,1.1; 95% CI, 0.5-2.2; P = .73).

CONCLUSION: Larger retinal venular caliber is independently associated with risk of cardiovascular disease in elderly persons.

VL - 166 IS - 21 U1 - https://www.ncbi.nlm.nih.gov/pubmed/17130394?dopt=Abstract ER -