You are here

Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study.

TitleQuantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study.
Publication TypeJournal Article
Year of Publication2006
AuthorsWong, TYin, Kamineni, A, Klein, R, A Sharrett, R, Klein, BE, Siscovick, DS, Cushman, M, Duncan, BB
JournalArch Intern Med
Volume166
Issue21
Pagination2388-94
Date Published2006 Nov 27
ISSN0003-9926
KeywordsAged, Aged, 80 and over, Algorithms, Cardiovascular Diseases, Cohort Studies, Female, Humans, Image Processing, Computer-Assisted, Incidence, Male, Photography, Prospective Studies, Retinal Diseases, Retinal Vein, Retinal Vessels, Risk Factors, Stroke, United States
Abstract<p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSION: </b>Larger retinal venular caliber is independently associated with risk of cardiovascular disease in elderly persons.</p>
DOI10.1001/archinte.166.21.2388
Alternate JournalArch Intern Med
PubMed ID17130394
Grant ListHC-97-06 / HC / NHLBI NIH HHS / United States
R01-HL077166 / HL / NHLBI NIH HHS / United States