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- Title
Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study.
- Authors
Wong TY; Klein R; Sharrett AR; Duncan BB; Couper DJ; Tielsch JM; Klein BEK; Hubbard LD; Wong, Tien Yin; Klein, Ronald; Sharrett, A Richey; Duncan, Bruce B; Couper, David J; Tielsch, James M; Klein, Barbara E K; Hubbard, Larry D
- Abstract
<bold>Context: </bold>Microvascular processes have been hypothesized to play a greater role in the development of coronary heart disease (CHD) in women than in men; however, prospective clinical data are limited.<bold>Objective: </bold>To examine the association between retinal arteriolar narrowing, a marker of microvascular damage from hypertension and inflammation, and incident CHD in healthy middle-aged women and men.<bold>Design, Setting, and Participants: </bold>The Atherosclerosis Risk in Communities Study, an ongoing prospective, population-based cohort study in 4 US communities initiated in 1987-1989. Retinal photographs were taken in 9648 women and men aged 51 to 72 years without CHD at the third examination (1993-1995). To quantify retinal arteriolar narrowing, the photographs were digitized, individual arteriolar and venular diameters were measured, and a summary arteriole-to-venule ratio (AVR) was calculated.<bold>Main Outcome Measure: </bold>Risk of CHD associated with retinal arteriolar narrowing.<bold>Results: </bold>During an average 3.5 years of follow-up, 84 women and 187 men experienced incident CHD events. In women, after controlling for mean arterial blood pressure averaged over the previous 6 years, diabetes, cigarette smoking, plasma lipid levels, and other risk factors, each SD decrease in the AVR was associated with an increased risk of any incident CHD (relative risk [RR], 1.37; 95% confidence interval [CI], 1.08-1.72) and of acute myocardial infarction (RR, 1.50; 95% CI, 1.10-2.04). In contrast, AVR was unrelated to any incident CHD in men (RR, 1.00; 95% CI, 0.84-1.18) or to acute myocardial infarction (RR, 1.08; 95% CI, 0.85-1.38).<bold>Conclusion: </bold>Retinal arteriolar narrowing is related to risk of CHD in women but not in men, supporting a more prominent microvascular role in the development of CHD in women than in men. Future work is needed to confirm these findings.
- Publication
JAMA: Journal of the American Medical Association, 2002, Vol 287, Issue 9, p1153
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.287.9.1153