Quantitative retinal venular caliber and risk of cardiovascular disease in older persons

The cardiovascular health study

Tien Yin Wong, Aruna Kamineni, Ronald Klein, A. Richey Sharrett, Barbara E. Klein, David S. Siscovick, Mary Cushman, Bruce B. Duncan

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: 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. Results: 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). Conclusion: Larger retinal venular caliber is independently associated with risk of cardiovascular disease in elderly persons.

Original languageEnglish (US)
Pages (from-to)2388-2394
Number of pages7
JournalArchives of Internal Medicine
Volume166
Issue number21
DOIs
StatePublished - Nov 27 2006

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Cardiovascular Diseases
Confidence Intervals
Coronary Disease
Stroke
Health
Heart Rate
Smoking
Tunica Intima
Blood Pressure
Retinal Vessels
Common Carotid Artery
Internal Carotid Artery
HDL Lipoproteins
C-Reactive Protein
LDL Cholesterol
Cohort Studies
Glucose
Incidence
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Wong, T. Y., Kamineni, A., Klein, R., Sharrett, A. R., Klein, B. E., Siscovick, D. S., ... Duncan, B. B. (2006). Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: The cardiovascular health study. Archives of Internal Medicine, 166(21), 2388-2394. https://doi.org/10.1001/archinte.166.21.2388

Quantitative retinal venular caliber and risk of cardiovascular disease in older persons : The cardiovascular health study. / Wong, Tien Yin; Kamineni, Aruna; Klein, Ronald; Sharrett, A. Richey; Klein, Barbara E.; Siscovick, David S.; Cushman, Mary; Duncan, Bruce B.

In: Archives of Internal Medicine, Vol. 166, No. 21, 27.11.2006, p. 2388-2394.

Research output: Contribution to journalArticle

Wong, TY, Kamineni, A, Klein, R, Sharrett, AR, Klein, BE, Siscovick, DS, Cushman, M & Duncan, BB 2006, 'Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: The cardiovascular health study', Archives of Internal Medicine, vol. 166, no. 21, pp. 2388-2394. https://doi.org/10.1001/archinte.166.21.2388
Wong, Tien Yin ; Kamineni, Aruna ; Klein, Ronald ; Sharrett, A. Richey ; Klein, Barbara E. ; Siscovick, David S. ; Cushman, Mary ; Duncan, Bruce B. / Quantitative retinal venular caliber and risk of cardiovascular disease in older persons : The cardiovascular health study. In: Archives of Internal Medicine. 2006 ; Vol. 166, No. 21. pp. 2388-2394.
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abstract = "Background: 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. Methods: 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. Results: 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). Conclusion: Larger retinal venular caliber is independently associated with risk of cardiovascular disease in elderly persons.",
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AU - Cushman, Mary

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N2 - Background: 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. Methods: 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. Results: 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). Conclusion: Larger retinal venular caliber is independently associated with risk of cardiovascular disease in elderly persons.

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