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Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study.
Ophthalmology. 2003 May; 110(5):933-40.O

Abstract

PURPOSE

Retinal microvascular abnormalities reflect persistent arteriolar damage from hypertension and independently predict stroke. We examined their associations with long-term cardiovascular mortality.

DESIGN

Population-based, nested, case-control study.

POPULATION

Cases were Beaver Dam Eye Study participants (age range, 43-84 years) who died of coronary heart disease or stroke between the baseline examination in 1988 to 1990 and 1999 (n = 413). Nearly 3 controls per case were selected from the baseline cohort, frequency-matched on 5-year age intervals and gender (n = 1198).

METHODS

Retinal photographs of cases and controls at baseline were evaluated for retinopathy, focal arteriolar narrowing, and arteriovenous nicking by graders masked to case-control status using standardized protocols. To obtain an estimate of generalized arteriolar narrowing, photographs were digitized and diameters of individual retinal vessels were measured and summarized by a computer program.

MAIN OUTCOME MEASURE

Ten-year cardiovascular mortality.

RESULTS

After controlling for systolic blood pressure, diabetes, glycosylated hemoglobin levels, and other risk factors, retinopathy was associated with increased cardiovascular mortality, with odds ratios of 1.8 (95% confidence interval [CI], 1.2, 2.7). For other retinal abnormalities, associations with cardiovascular mortality were present only in younger people, with odds ratios of 2.7 (95% CI, 1.0, 7.4) for focal arteriolar narrowing, 1.8 (95% CI, 0.8, 4.5) for arteriovenous nicking, and 1.9 (95% CI, 1.2, 2.9) for generalized arteriolar narrowing in persons 43 to 74 years of age but odds ratios of 1.1, 0.4, and 1.0 for the corresponding retinal abnormalities in persons 75 years and older.

CONCLUSIONS

Retinopathy is independently associated with cardiovascular mortality. Associations for other retinal abnormalities were only observed in middle-aged persons. These data support recent studies that suggest retinal microvascular abnormalities provide independent information regarding cardiovascular risk.

Authors+Show Affiliations

Singapore National Eye Center & National University of Singapore, 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 available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12750093

Citation

Wong, Tien Yin, et al. "Retinal Microvascular Abnormalities and 10-year Cardiovascular Mortality: a Population-based Case-control Study." Ophthalmology, vol. 110, no. 5, 2003, pp. 933-40.
Wong TY, Klein R, Nieto FJ, et al. Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study. Ophthalmology. 2003;110(5):933-40.
Wong, T. Y., Klein, R., Nieto, F. J., Klein, B. E., Sharrett, A. R., Meuer, S. M., Hubbard, L. D., & Tielsch, J. M. (2003). Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study. Ophthalmology, 110(5), 933-40.
Wong TY, et al. Retinal Microvascular Abnormalities and 10-year Cardiovascular Mortality: a Population-based Case-control Study. Ophthalmology. 2003;110(5):933-40. PubMed PMID: 12750093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study. AU - Wong,Tien Yin, AU - Klein,Ronald, AU - Nieto,F Javier, AU - Klein,Barbara E K, AU - Sharrett,A Richey, AU - Meuer,Stacy M, AU - Hubbard,Larry D, AU - Tielsch,James M, PY - 2003/5/17/pubmed PY - 2003/5/31/medline PY - 2003/5/17/entrez SP - 933 EP - 40 JF - Ophthalmology JO - Ophthalmology VL - 110 IS - 5 N2 - PURPOSE: Retinal microvascular abnormalities reflect persistent arteriolar damage from hypertension and independently predict stroke. We examined their associations with long-term cardiovascular mortality. DESIGN: Population-based, nested, case-control study. POPULATION: Cases were Beaver Dam Eye Study participants (age range, 43-84 years) who died of coronary heart disease or stroke between the baseline examination in 1988 to 1990 and 1999 (n = 413). Nearly 3 controls per case were selected from the baseline cohort, frequency-matched on 5-year age intervals and gender (n = 1198). METHODS: Retinal photographs of cases and controls at baseline were evaluated for retinopathy, focal arteriolar narrowing, and arteriovenous nicking by graders masked to case-control status using standardized protocols. To obtain an estimate of generalized arteriolar narrowing, photographs were digitized and diameters of individual retinal vessels were measured and summarized by a computer program. MAIN OUTCOME MEASURE: Ten-year cardiovascular mortality. RESULTS: After controlling for systolic blood pressure, diabetes, glycosylated hemoglobin levels, and other risk factors, retinopathy was associated with increased cardiovascular mortality, with odds ratios of 1.8 (95% confidence interval [CI], 1.2, 2.7). For other retinal abnormalities, associations with cardiovascular mortality were present only in younger people, with odds ratios of 2.7 (95% CI, 1.0, 7.4) for focal arteriolar narrowing, 1.8 (95% CI, 0.8, 4.5) for arteriovenous nicking, and 1.9 (95% CI, 1.2, 2.9) for generalized arteriolar narrowing in persons 43 to 74 years of age but odds ratios of 1.1, 0.4, and 1.0 for the corresponding retinal abnormalities in persons 75 years and older. CONCLUSIONS: Retinopathy is independently associated with cardiovascular mortality. Associations for other retinal abnormalities were only observed in middle-aged persons. These data support recent studies that suggest retinal microvascular abnormalities provide independent information regarding cardiovascular risk. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/12750093/Retinal_microvascular_abnormalities_and_10_year_cardiovascular_mortality:_a_population_based_case_control_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(03)00084-8 DB - PRIME DP - Unbound Medicine ER -