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The prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study.
Ophthalmology. 2003 Apr; 110(4):658-66.O

Abstract

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.

Authors+Show Affiliations

Singapore Eye Research Institute, Singapore, Republic of Singapore. ophwty@nus.edu.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12689883

Citation

Wong, Tien Yin, et al. "The Prevalence and Risk Factors of Retinal Microvascular Abnormalities in Older Persons: the Cardiovascular Health Study." Ophthalmology, vol. 110, no. 4, 2003, pp. 658-66.
Wong TY, Klein R, Sharrett AR, et al. The prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study. Ophthalmology. 2003;110(4):658-66.
Wong, T. Y., Klein, R., Sharrett, A. R., Manolio, T. A., Hubbard, L. D., Marino, E. K., Kuller, L., Burke, G., Tracy, R. P., Polak, J. F., Gottdiener, J. S., & Siscovick, D. S. (2003). The prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study. Ophthalmology, 110(4), 658-66.
Wong TY, et al. The Prevalence and Risk Factors of Retinal Microvascular Abnormalities in Older Persons: the Cardiovascular Health Study. Ophthalmology. 2003;110(4):658-66. PubMed PMID: 12689883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study. AU - Wong,Tien Yin, AU - Klein,Ronald, AU - Sharrett,A Richey, AU - Manolio,Teri A, AU - Hubbard,Larry D, AU - Marino,Emily K, AU - Kuller,Lewis, AU - Burke,Gregory, AU - Tracy,Russell P, AU - Polak,Joseph F, AU - Gottdiener,John S, AU - Siscovick,David S, PY - 2003/4/12/pubmed PY - 2003/5/8/medline PY - 2003/4/12/entrez SP - 658 EP - 66 JF - Ophthalmology JO - Ophthalmology VL - 110 IS - 4 N2 - 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. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/12689883/The_prevalence_and_risk_factors_of_retinal_microvascular_abnormalities_in_older_persons:_The_Cardiovascular_Health_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(02)01931-0 DB - PRIME DP - Unbound Medicine ER -