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Retinal microvascular signs and risk of stroke and stroke mortality.
Neurology. 2005 Oct 11; 65(7):1005-9.Neur

Abstract

OBJECTIVE

The purpose of this study was to assess the relation of retinal microvascular signs and incident stroke and stroke mortality in an older population.

METHODS

The authors took retinal photographs on baseline participants (3,654 patients aged 49+ years) of the Blue Mountains Eye Study (1992 to 1994). They assessed the presence of retinopathy (microaneurysms, retinal hemorrhages) in participants without diabetes and retinal arteriolar signs in all participants using standardized grading protocols. Incident stroke/TIA/cerebrovascular death (combined stroke events) were identified at follow-up examinations during 1997 to 1999.

RESULTS

During a 7-year period, 859 participants died, 97 (11.3%) of which died of cerebrovascular causes. Of survivors, 24 had confirmed incident stroke, and 11 had incident TIA. Combined stroke events were more frequent in participants with retinopathy (5.7%), with moderate/severe arteriovenous nicking (4.2%), or with focal arteriolar narrowing (7.2%) compared with those without (1.9%). After controlling for age, sex, systolic blood pressure, smoking, and self-rated health, retinopathy was significantly associated with combined stroke events (relative risk [RR] 1.7, 95% CI 1.0 to 2.8) in persons without diabetes. This association was stronger in those without severe hypertension (RR 2.7, CI 1.2 to 6.2) or in persons with two or more retinal microvascular signs (RR 2.7, CI 1.5 to 5.2). Generalized or focal arteriolar narrowing or arteriovenous nicking was not independently associated with combined stroke events after multivariate adjustment.

CONCLUSIONS

In older Australians without diabetes, retinopathy signs predict stroke or stroke-related death independent of traditional stroke risk factors.

Authors+Show Affiliations

Centre for Vision Research, Department of Ophthalmology, Westmead Millennium and Save Sight Institutes, University of Sydney, Australia. paul_mitchell@wmi.usyd.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16217050

Citation

Mitchell, P, et al. "Retinal Microvascular Signs and Risk of Stroke and Stroke Mortality." Neurology, vol. 65, no. 7, 2005, pp. 1005-9.
Mitchell P, Wang JJ, Wong TY, et al. Retinal microvascular signs and risk of stroke and stroke mortality. Neurology. 2005;65(7):1005-9.
Mitchell, P., Wang, J. J., Wong, T. Y., Smith, W., Klein, R., & Leeder, S. R. (2005). Retinal microvascular signs and risk of stroke and stroke mortality. Neurology, 65(7), 1005-9.
Mitchell P, et al. Retinal Microvascular Signs and Risk of Stroke and Stroke Mortality. Neurology. 2005 Oct 11;65(7):1005-9. PubMed PMID: 16217050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal microvascular signs and risk of stroke and stroke mortality. AU - Mitchell,P, AU - Wang,J J, AU - Wong,T Y, AU - Smith,W, AU - Klein,R, AU - Leeder,S R, PY - 2005/10/12/pubmed PY - 2006/3/10/medline PY - 2005/10/12/entrez SP - 1005 EP - 9 JF - Neurology JO - Neurology VL - 65 IS - 7 N2 - OBJECTIVE: The purpose of this study was to assess the relation of retinal microvascular signs and incident stroke and stroke mortality in an older population. METHODS: The authors took retinal photographs on baseline participants (3,654 patients aged 49+ years) of the Blue Mountains Eye Study (1992 to 1994). They assessed the presence of retinopathy (microaneurysms, retinal hemorrhages) in participants without diabetes and retinal arteriolar signs in all participants using standardized grading protocols. Incident stroke/TIA/cerebrovascular death (combined stroke events) were identified at follow-up examinations during 1997 to 1999. RESULTS: During a 7-year period, 859 participants died, 97 (11.3%) of which died of cerebrovascular causes. Of survivors, 24 had confirmed incident stroke, and 11 had incident TIA. Combined stroke events were more frequent in participants with retinopathy (5.7%), with moderate/severe arteriovenous nicking (4.2%), or with focal arteriolar narrowing (7.2%) compared with those without (1.9%). After controlling for age, sex, systolic blood pressure, smoking, and self-rated health, retinopathy was significantly associated with combined stroke events (relative risk [RR] 1.7, 95% CI 1.0 to 2.8) in persons without diabetes. This association was stronger in those without severe hypertension (RR 2.7, CI 1.2 to 6.2) or in persons with two or more retinal microvascular signs (RR 2.7, CI 1.5 to 5.2). Generalized or focal arteriolar narrowing or arteriovenous nicking was not independently associated with combined stroke events after multivariate adjustment. CONCLUSIONS: In older Australians without diabetes, retinopathy signs predict stroke or stroke-related death independent of traditional stroke risk factors. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/16217050/Retinal_microvascular_signs_and_risk_of_stroke_and_stroke_mortality_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=16217050 DB - PRIME DP - Unbound Medicine ER -