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T.Y. Wong, A. Kamineni, R. Klein, A. Sharrett, B.E. K. Klein, D.S. Siscovick, M. Cushman, B.B. Duncan; Retinal Vascular Caliber and Risk of Coronary Heart Disease and Stroke: The Cardiovascular Health Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):927.
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To describe the relationship of retinal vascular caliber and incident coronary heart disease (CHD) and stroke in elderly persons
Population–based, prospective cohort study comprising 1,992 men and women aged 69 to 97 years living in four US communities. Participants had retinal photography according to standardized protocol in 1997–98. Retinal vascular calibers were obtained using a computer–assisted method to obtain an estimate of average arteriolar and venular caliber of the eye. Incident CHD and stroke events were ascertained using standardized methods.
During 5 years of follow–up, 177 incident CHD events and 113 incident stroke events were ascertained. Participants with wider retinal venular caliber had a higher incidence of CHD (16.3% vs. 11.7%, comparing extreme venular caliber quartiles) and stroke (8.4% vs. 5.8%). In multivariable analysis adjusting for age, gender, race/center, systolic blood pressure, fasting plasma glucose, cigarette smoking status and total plasma cholesterol levels, wider retinal venular caliber was associated with greater incident CHD (relative risk [RR] 1.7, 95% confidence interval [CI], 1.1 – 2.7, comparing extreme venular caliber quartiles) and stroke (RR 2.0, 95% CI, 1.1 – 3.5). Additional adjustment for C–reactive protein attenuated the association for incident CHD (RR 1.4, 95% CI, 0.9 – 2.3) but not for incident stroke (RR 2.1, 95% CI, 1.0 – 4.1). Retinal arteriolar caliber was not associated with incident CHD or stroke.
Retinal venular caliber is a predictor of cardiovascular disease, particularly stroke, in elderly persons. This suggests that retinal photography may be an additional tool for cardiovascular risk stratification in appropriate populations.
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