The prevalence and risk factors of retinal microvascular abnormalities in older persons: The cardiovascular health study

Tien Yin Wong, Ronald Klein, A. Richey Sharrett, Teri A. Manolio, Larry D. Hubbard, Emily K. Marino, Lewis Kuller, Gregory Burke, Russell P. Tracy, Joseph F. Polak, John S. Gottdiener, David S. Siscovick

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)658-666
Number of pages9
JournalOphthalmology
Volume110
Issue number4
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

Fingerprint

Odds Ratio
Atherosclerosis
Health
Hypertension
Coronary Disease
Arterial Pressure
Stroke
Retinal Hemorrhage
Carotid Intima-Media Thickness
Venules
Photography
Carotid Stenosis
Arterioles
Carotid Arteries
Antihypertensive Agents
Arteries
Cross-Sectional Studies
Myocardial Infarction
Outcome Assessment (Health Care)
Population

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wong, T. Y., Klein, R., Sharrett, A. R., Manolio, T. A., Hubbard, L. D., Marino, E. K., ... Siscovick, D. S. (2003). The prevalence and risk factors of retinal microvascular abnormalities in older persons: The cardiovascular health study. Ophthalmology, 110(4), 658-666. https://doi.org/10.1016/S0161-6420(02)01931-0

The prevalence and risk factors of retinal microvascular abnormalities in older persons : The cardiovascular health study. / Wong, Tien Yin; Klein, Ronald; Sharrett, A. Richey; Manolio, Teri A.; Hubbard, Larry D.; Marino, Emily K.; Kuller, Lewis; Burke, Gregory; Tracy, Russell P.; Polak, Joseph F.; Gottdiener, John S.; Siscovick, David S.

In: Ophthalmology, Vol. 110, No. 4, 01.04.2003, p. 658-666.

Research output: Contribution to journalArticle

Wong, TY, Klein, R, Sharrett, AR, Manolio, TA, Hubbard, LD, Marino, EK, Kuller, L, Burke, G, Tracy, RP, Polak, JF, Gottdiener, JS & Siscovick, DS 2003, 'The prevalence and risk factors of retinal microvascular abnormalities in older persons: The cardiovascular health study', Ophthalmology, vol. 110, no. 4, pp. 658-666. https://doi.org/10.1016/S0161-6420(02)01931-0
Wong, Tien Yin ; Klein, Ronald ; Sharrett, A. Richey ; Manolio, Teri A. ; Hubbard, Larry D. ; Marino, Emily K. ; Kuller, Lewis ; Burke, Gregory ; Tracy, Russell P. ; Polak, Joseph F. ; Gottdiener, John S. ; Siscovick, David S. / The prevalence and risk factors of retinal microvascular abnormalities in older persons : The cardiovascular health study. In: Ophthalmology. 2003 ; Vol. 110, No. 4. pp. 658-666.
@article{d433615965f443b7b4611161b686c542,
title = "The prevalence and risk factors of retinal microvascular abnormalities in older persons: The cardiovascular health study",
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.",
author = "Wong, {Tien Yin} and Ronald Klein and Sharrett, {A. Richey} and Manolio, {Teri A.} and Hubbard, {Larry D.} and Marino, {Emily K.} and Lewis Kuller and Gregory Burke and Tracy, {Russell P.} and Polak, {Joseph F.} and Gottdiener, {John S.} and Siscovick, {David S.}",
year = "2003",
month = "4",
day = "1",
doi = "10.1016/S0161-6420(02)01931-0",
language = "English (US)",
volume = "110",
pages = "658--666",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - The prevalence and risk factors of retinal microvascular abnormalities in older persons

T2 - 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 - 2003/4/1

Y1 - 2003/4/1

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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0037397046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037397046&partnerID=8YFLogxK

U2 - 10.1016/S0161-6420(02)01931-0

DO - 10.1016/S0161-6420(02)01931-0

M3 - Article

C2 - 12689883

AN - SCOPUS:0037397046

VL - 110

SP - 658

EP - 666

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 4

ER -