on April 3, 2006
Published online before print April 3, 2006, doi: 10.1161/01.HYP.0000216717.72048.6c
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on October 5, 2005
From the Department of Clinical Pharmacology (N.W., A.D.H., N.C., R.E., M.M., S.A.M.T.), National Heart and Lung Institute Division, International Centre for Circulatory Health, Faculty of Medicine, Imperial College London, United Kingdom; Centre for Eye Research Australia (T.Y.W.), University of Melbourne, Australia; and Department of Ophthalmology and Visual Sciences (B.E.K., R.K.), University of Wisconsin Medical School, Madison. * To whom correspondence should be addressed. E-mail: a.hughes{at}imperial.ac.uk.
Abstract--Abnormalities of the retinal microcirculation are found in hypertension and diabetes and predict cardiovascular mortality. This study examined the relationship between abnormalities of the retinal microvasculature and death from ischemic heart disease (IHD) and stroke. A population-based, nested case-control study was undertaken within the Beaver Dam Eye Study. Subjects (43 to 74 years) who died of IHD (n=126) or stroke (n=28) over a 10-year period were age and gender matched with controls subjects (n=528; case:control matching,
Revised on October 24, 2005
Abnormalities of Retinal Microvascular Structure and Risk of Mortality From Ischemic Heart Disease and Stroke
Nicholas Witt;
1:4). Retinal photographs of cases and controls were digitized and analyzed using a computer-based technique. Increased risk of IHD death was associated with a suboptimal relationship of arteriolar diameters at bifurcation (P=0.02 unadjusted) and decreased retinal arteriolar tortuosity (P=0.011 unadjusted). These associations remained significant after adjustment for age, sex, past history of cardiovascular disease, and other known cardiovascular risk factors. Increased arteriolar length:diameter ratio, a measure of generalized arteriolar narrowing, was associated with increased stroke mortality (P=0.02 unadjusted). This association was independent of age and gender but was attenuated by adjustment for systolic blood pressure (P=0.15). Other quantitative measures of the retinal microvascular network (eg, venular tortuosity and arteriolar and venular bifurcation angle) were not associated with death from IHD or stroke. Retinal microvascular abnormalities are predictive of death from IHD and stroke. A detailed assessment of the retinal microvascular network from digitized photographs may be useful in the noninvasive assessment of target organ damage and cardiovascular risk.
Key words: stroke • cardiovascular diseases • coronary diseases • microcirculation
This article has been cited by other articles:
 |
|
 |
|
  N C B B Taarnhoj, I C Munch, B Sander, L Kessel, J L Hougaard, K Kyvik, T I A Sorensen, and M Larsen Straight versus tortuous retinal arteries in relation to blood pressure and genetics Br. J. Ophthalmol., August 1, 2008; 92(8): 1055 - 1060. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Williams The year in hypertension. J. Am. Coll. Cardiol., May 6, 2008; 51(18): 1803 - 1817. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Cheng, C. Daskalakis, and B. Falkner Original Research: Capillary rarefaction in treated and untreated hypertensive subjects Therapeutic Advances in Cardiovascular Disease, April 1, 2008; 2(2): 79 - 88. [Abstract] [PDF]
|
|
|
|
 |
|
 R. J. Tapp, C. Williams, N. Witt, N. Chaturvedi, R. Evans, S. A. M. Thom, A. D. Hughes, and A. Ness Impact of Size at Birth on the Microvasculature: The Avon Longitudinal Study of Parents and Children Pediatrics, November 1, 2007; 120(5): e1225 - e1228. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. T. Nguyen, J. J. Wang, and T. Y. Wong Retinal Vascular Changes in Pre-Diabetes and Prehypertension: New findings and their research and clinical implications Diabetes Care, October 1, 2007; 30(10): 2708 - 2715. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Harazny, M. Ritt, D. Baleanu, C. Ott, J. Heckmann, M. P. Schlaich, G. Michelson, and R. E. Schmieder Increased Wall:Lumen Ratio of Retinal Arterioles in Male Patients With a History of a Cerebrovascular Event Hypertension, October 1, 2007; 50(4): 623 - 629. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. E. Hirai, S. E. Moss, M. D. Knudtson, B. E. K. Klein, and R. Klein Retinopathy and Survival in a Population without Diabetes: The Beaver Dam Eye Study Am. J. Epidemiol., September 15, 2007; 166(6): 724 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Chao, M.-Y. Lai, S. P. Azen, R. Klein, R. Varma, and the Los Angeles Latino Eye Study Group Retinopathy in Persons without Diabetes: The Los Angeles Latino Eye Study Invest. Ophthalmol. Vis. Sci., September 1, 2007; 48(9): 4019 - 4025. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Rose, T. Y. Wong, A. P. Carson, D. J. Couper, R. Klein, and A. R. Sharrett Migraine and retinal microvascular abnormalities: The Atherosclerosis Risk in Communities Study Neurology, May 15, 2007; 68(20): 1694 - 1700. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Patton, A. Pattie, T. MacGillivray, T. Aslam, B. Dhillon, A. Gow, J. M. Starr, L. J. Whalley, and I. J. Deary The Association between Retinal Vascular Network Geometry and Cognitive Ability in an Elderly Population Invest. Ophthalmol. Vis. Sci., May 1, 2007; 48(5): 1995 - 2000. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Mitchell, N. Cheung, K. de Haseth, B. Taylor, E. Rochtchina, F. M. A. Islam, J. J. Wang, S. M. Saw, and T. Y. Wong Blood Pressure and Retinal Arteriolar Narrowing in Children Hypertension, May 1, 2007; 49(5): 1156 - 1162. [Abstract] [Full Text] [PDF]
|
|