Journal
EUROPEAN HEART JOURNAL
Volume 28, Issue 16, Pages 1984-1992Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehm221
Keywords
retinal microvasculature; mortality; stroke; coronary heart disease; population-based cohort; Beaver Dam Eye Study; Blue Mountains Eye Study
Categories
Funding
- NEI NIH HHS [EY 06594] Funding Source: Medline
- NHLBI NIH HHS [HL 59259] Funding Source: Medline
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Aims The retinal microvasculature may reflect pre-clinical changes in the cerebral and coronary microcirculations. We assessed whether smaller retinal arterioles and larger venules predicted coronary heart disease (CHD)- and stroke-mortality. Methods and results We pooled data from the Beaver Dam Eye Study (n = 4926, aged 43-86) and the Blue Mountains Eye Study (n = 3654, aged 49-97). Retinal vessel diameters were measured from digitized retinal photographs. Change point models were used to assess and document the existence of threshold effects. We defined smaller arterioles as diameters within the narrowest quintile and larger venules as diameters within the widest quintile, with other quintiles as the reference. Of 8550 participants, 7494 (88%) with complete data were included, of whom 653 died from CHD and 299 from stroke over 10-12 years follow-up. After multivariable adjustment, each standard deviation (SD) increase in arteriolar diameter, or SD decrease in venular diameter, was not found to be significantly associated with either CHD-mortality or stroke-mortality. However, smaller arterioles [hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.11-1.62] and larger venules (HR 1.24, CI 1.02-1.52), predicted increased risk of CHD-mortality. These associations were mainly evident among persons aged 43-69 (smaller arterioles: HR 1.70, CI 1.27-2.28; larger venules: HR 1.41, CI 1.06-1.89). Smaller arterioles (HR 1.64, CI 1.00-2.67) and Larger venules (HR 1.53, CI 0.94-2.47) were also associated with an increased risk of stroke-mortality among persons aged 43-69. Conclusion Retinal vessel diameter may predict risk of CHD and stroke deaths in middle-aged persons.
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