Retinal Vessel Calibers in Predicting Long-Term Cardiovascular Outcomes: The Atherosclerosis Risk in Communities Study
Authors' conclusion
Narrower retinal arterioles and wider retinal venules conferred long-term risk of mortality and ischemic stroke in both sexes and coronary heart disease in women.
Study context
- Population
- Men and women without prior atherosclerotic CVD events or HF in the ARIC Study, retinal photography at visit 3 (1993–1995)
- Participants
- 10,470 men
- Exposure
- Wider retinal venules and narrower retinal arterioles
- Outcome
- Incident CHD, ischemic stroke, HF and death; incremental value over 2013 ACC/AHA Pooled Cohort Equations
- Follow-up
- Mean 16 years
Main finding
As reported in the abstract
Death, ischemic stroke and incident CHD (women) by retinal vessel caliber
Hazard ratio (95% CI)
Wider retinal venulesper 1-SD increase; 1st of 3 HRs
1.13(1.08–1.18)
Wider retinal venulesper 1-SD increase; 2nd of 3 HRs
1.18(1.07–1.31)
Wider retinal venulesper 1-SD increase; 3rd of 3 HRs
1.10(1.00–1.20)
Narrower retinal arteriolesper 1-SD decrease; 1st of 3 HRs
1.06(1.01–1.11)
Narrower retinal arteriolesper 1-SD decrease; 2nd of 3 HRs
1.14(1.03–1.26)
Narrower retinal arteriolesper 1-SD decrease; 3rd of 3 HRs
1.13(1.03–1.24)
Each row per its own increment, as printed
- Higher risk of death and stroke in both sexes and incident CHD in women but not men
- interaction P=0.02
Observational data: associations, not effects.
Further findings
HF
- Association with HF nonsignificant after adjustment for SBP
10-year atherosclerotic CVD event rate, women with predicted risk <5% (overall risk 3.9%)
- Narrowest arteriolar quartile
- 5.6%
- Widest arteriolar quartile
- 2.8%
- Wider venules
- 5.0%
- Narrower venules
- 3.4%
- Low-risk women reclassified as intermediate risk (>5%)
- 21%
- All women reclassified as intermediate risk
- 11%
Original publication
Retinal Vessel Calibers in Predicting Long-Term Cardiovascular Outcomes: The Atherosclerosis Risk in Communities Study. Circulation. Published 28 September 2016. doi:10.
Summarised from the published abstract; every number is checked against it