Central arterial stiffness and retinal vessel calibers: the Atherosclerosis Risk in Communities Study–Neurocognitive Study

Meyer, Michelle L.; Klein, Barbara E. K.; Klein, Ronald; Palta, Priya; Sharrett, A. Richey; Heiss, Gerardo; Nambi, Vijay; Wong, Tien Yin; Tanaka, Hirofumi

doi:10.1097/hjh.0000000000002252

Cited by 22 publications

(19 citation statements)

References 55 publications

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“…In contrast to previous studies, 11 , 12 , 13 , 14 , 15 we observed no association between arterial stiffness and narrower retinal arteriolar diameters, possibly because inward remodeling (the proximate cause of arteriolar narrowing) 3 occurs in a more advanced disease stage than was present in the population that we studied. Additionally, and similar to most previous studies, 11 , 14 , 15 we observed no association of arterial stiffness with retinal venular diameters, possibly because hemodynamic stress in venules is insufficient to affect their structure.…”

Section: Discussioncontrasting

confidence: 99%

Carotid stiffness is associated with retinal microvascular dysfunction—The Maastricht study

et al. 2021

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Objective This study investigated whether arterial stiffening is a determinant of subtle retinal microvascular changes that precede diabetic retinopathy. Research design and methods This study used cross‐sectional data from the Maastricht Study, a type 2 diabetes‐enriched population‐based cohort study. We used multivariable linear regression analysis to investigate, in individuals without and with type 2 diabetes, the associations of carotid distensibility coefficient and carotid‐femoral pulse wave velocity with retinal microvascular diameters and flicker light‐induced dilation and adjusted for cardiovascular and lifestyle risk factors. Results The retinal microvascular diameter study population consisted of N = 2434 participants (51.4% men, mean ± SD age 59.8 ± 8.1 years, and 28.1% type 2 diabetes). No measures of arterial stiffness were significantly associated with microvascular diameters. Greater carotid distensibility coefficient (i.e., lower carotid stiffness) was significantly associated with greater retinal arteriolar flicker light‐induced dilation (per standard deviation, standardized beta [95% CI] 0.06 [0.00; 0.12]) and non‐significantly, but directionally similarly, associated with greater retinal venular flicker light‐induced dilation (0.04 [−0.02; 0.10]). Carotid‐femoral pulse wave velocity (i.e., aortic stiffness) was not associated with retinal microvascular flicker light‐induced dilation. The associations between carotid distensibility coefficient and retinal arteriolar and venular flicker light‐induced dilation were two‐ to threefold stronger in individuals with type 2 diabetes than in those without. Conclusion In this population‐based study greater carotid, but not aortic, stiffness was associated with worse retinal flicker light‐induced dilation and this association was stronger in individuals with type 2 diabetes. Hence, carotid stiffness may be a determinant of retinal microvascular dysfunction.

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Section: Discussioncontrasting

confidence: 99%

Carotid stiffness is associated with retinal microvascular dysfunction—The Maastricht study

et al. 2021

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“…A previous study found increased PWV was associated with wider retinal venular caliber in the Atherosclerosis Risk in Communities Study 30 . Current guidelines by the European Society of Hypertension state that a measured PWV larger than 10 m/s can be considered an independent marker of HMOD 8 .…”

Section: Discussionmentioning

confidence: 76%

Retinal capillary rarefaction is associated with arterial and kidney damage in hypertension

Frost

Nolde

Chan

et al. 2021

Sci Rep

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Microvascular disease and rarefaction are key pathological hallmarks of hypertension. The retina uniquely allows direct, non-invasive investigation of the microvasculature. Recently developed optical coherence tomography angiography now allows investigation of the fine retinal capillaries, which may provide a superior marker of overall vascular damage. This was a prospective cross-sectional study to collect retinal capillary density data on 300 normal eyes from 150 hypertensive adults, and to investigate possible associations with other organ damage markers. The average age of participants was 54 years and there was a greater proportion of males (85; 57%) than females. Multivariate, confounder adjusted linear regression showed that retinal capillary rarefaction in the parafovea was associated with increased pulse wave velocity (β = − 0.4, P = 0.04), log-albumin/creatinine ratio (β = − 0.71, P = 0.003), and with reduced estimated glomerular filtration rate (β = 0.04, P = 0.02). Comparable significant associations were also found for whole-image vascular-density, for foveal vascular-density significant associations were found with pulse wave velocity and estimated glomerular filtration rate only. Our results indicate that retinal capillary rarefaction is associated with arterial stiffness and impaired kidney function. Retinal capillary rarefaction may represent a useful and simple test to assess the integrated burden of hypertension on the microvasculature irrespective of current blood pressure levels.

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“…Микроваскулярная дисфункция служит одним из ключевых факторов патогенеза АГ. Сужение артериол и расширение венул сетчатки могут нести неодинаковую информативную прогностическую нагрузку, поэтому их дифференцированная оценка играет более значимую роль, нежели определение артериовенозного соотношения [7]. Наряду с сужением артериол сетчатки расширение венул способно независимо от других факторов коррелировать с вероятностью выявления АГ [7].…”

Section: Discussionunclassified

“…Сужение артериол и расширение венул сетчатки могут нести неодинаковую информативную прогностическую нагрузку, поэтому их дифференцированная оценка играет более значимую роль, нежели определение артериовенозного соотношения [7]. Наряду с сужением артериол сетчатки расширение венул способно независимо от других факторов коррелировать с вероятностью выявления АГ [7]. Установлено, что дилатация ретинальных венул ассоциирована с системным низкоинтенсивным воспалением, лабораторными и инструментальными маркерами атеросклероза, эндотелиальной дисфункции, фиброза и другими метаболическими отклонениями [8].…”

Section: Discussionunclassified

“…Взаимосвязь калибра ретинальных сосудов с факторами сердечно-сосудистого риска в целом известна. Выявленная в нашем исследовании обратная корреляция артериовенозного соотношения с сывороточным уровнем ХС ЛНП в определённой мере соответствует результатам, установленным в значительно более масштабных исследовательских проектах [7,9,10]. Авторы этих исследований констатировали, что в подобной ассоциации расширение венул играет большую роль, нежели констрикция артериол.…”

Section: Discussionunclassified

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Gender characteristics of retinal parameters in patients with uncomplicated hypertension

Барсуков

Shcherbakova

Burnasheva

et al. 2020

Cardiovasc Ther Prev

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Aim. To establish gender specificities of retinal arteriolar and venular diameters, foveal avascular zone (FAZ) area, subfoveal choroid thickness (SCT), and to determine their association with cardiovascular risk and prognosis in patients with uncomplicated hypertension (HTN).Material and methods. The study included 70 patients (56 males and 14 females) aged 45-59 years with stage I or II HTN. There were following exclusion criteria: diabetes, liver failure, clinically relevant ophthalmic pathology. We assessed routine hemodynamic parameters, biochemical profile, serum N-terminal procollagen-III peptide, urinary albumin-creatinine ratio, 24-hour urinary albumin excretion, retinal parameters. All patients underwent electrocardiography and echocardiography. Ten-year risk of fatal cardiovascular disease (SCORE) was estimated. Based on scanning laser ophthalmoscopy, central retinal arterial (CRAE) and venous (CRVE) equivalents, arteriovenous ratio (AVR) were calculated. Using optical coherence tomography angiography, we determined FAZ area and SCT. Data processing was performed using StatSoft Statistica 10.Results. Hypertensive women were characterized by significantly larger FAZ area (p<0,001), CRVE (p=0,005), CRAE (p=0,012) compared with men. SCT values (p>0,05) were comparable. CRVE was associated with Cornell voltage product (r=0,3) in the male group. In women, age was negatively correlated with SCT (r=-0,54); SCORE value was inversely associated with SCT (r=-0,56), AVR (r=-0,53), CRAE (r=-0,3).Conclusion. In patients with uncomplicated HTN, the gender specificities of retina are manifested by a relative decrease of arteriolar diameters in males and a relative increase of venular diameters and FAZ in females. SCT decreases most clearly with age among hypertensive women. Men are characterized by a direct association of retinal venular diameters with a quantitative electrocardiographic marker of left ventricular hypertrophy. In women, there are an inverse association of SCT and arteriolar diameters with a ten-year risk of fatal cardiovascular disease.

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Central arterial stiffness and retinal vessel calibers: the Atherosclerosis Risk in Communities Study–Neurocognitive Study

Cited by 22 publications

References 55 publications

Carotid stiffness is associated with retinal microvascular dysfunction—The Maastricht study

Carotid stiffness is associated with retinal microvascular dysfunction—The Maastricht study

Retinal capillary rarefaction is associated with arterial and kidney damage in hypertension

Gender characteristics of retinal parameters in patients with uncomplicated hypertension

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