Relative importance of systemic determinants of retinal arteriolar and venular caliber: The atherosclerosis risk in communities study

Objective: To examine the relative contributions of systemic cardiovascular factors to retinal arteriolar and venular caliber in men and women and in whites and African Americans. Methods: In the Atherosclerosis Risk in Communities study, retinal arteriolar caliber (central retinal arteriolar equivalent), and venular caliber (central retinal venular equivalent) were measured from digitized retinal photographs of 8794 participants. Results: The main systemic determinants of narrower central retinal arteriolar equivalent were, in order of relative decreasing contribution, higher current mean arterial blood pressure, lower serum albumin level, current alcohol consumption, and higher body mass index (calculated as weight in kilograms divided by height in meters squared). The main systemic determinants of wider central retinal venular equivalent were current cigarette smoking and higher current mean arterial blood pressure, followed by higher white blood cell count, body mass index, and plasma low-density lipoprotein cholesterol levels. These associations were generally similar in whites and African Americans and in men and women. Conclusions: The major systemic determinant of narrower retinal arteriolar caliber is higher blood pressure, while those of wider retinal venular caliber are cigarette smoking, higher blood pressure, systemic inflammation, and obesity. These data offer further insights into the systemic processes influencing arteriolar and venular characteristics and may help explain the observed associations of retinal vascular caliber and the risk of clinical cardiovascular disease.