Regular aspirin use and retinal microvascular signs: the Blue Mountains Eye Study

Liew, Gerald; Mitchell, Paul; Leeder, Stephen; Smith, Wayne; Wong, Tien Yin; Wang, Jie Jin

doi:10.1097/01.hjh.0000234113.33025.33

Cited by 18 publications

(14 citation statements)

References 35 publications

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“…In a cross-sectional analysis, NSAID use in general was shown to be related to wider CRVE in the BDES, 44 although the Blue Mountains Eye Study did not find an association of aspirin use with CRVE. 45 When we excluded WBC count, a measure of systemic inflammation for which NSAIDs may have been taken, from the multivariate model, NSAID use became independently associated with smaller concurrent CRVE but not change in CRVE, and in a separate multivariate model excluding WBC count, aspirin use specifically was associated with a greater decrease in CRVE over time but not concurrent CRVE (data not shown).…”

Section: Discussionmentioning

confidence: 95%

Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

et al. 2012

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Objective To describe how retinal venular diameter changes over time for an individual and to examine differences in these changes among people with different risk profiles. Design Population-based cohort study. Participants 4600 persons aged 43–86 years from the Beaver Dam Eye Study who participated in at least 1 examination and had venular diameter measured in the right eye. Methods Data from 4 examinations over 15 years were analyzed. Retinal venular diameter was measured from photographs at each examination by computer-assisted methods and summarized as the central retinal venular equivalent (CRVE). Associations of risk factors to concurrent CRVE measurements and changes in CRVE over time were determined using multivariate analyses. Main Outcome Measure CRVE. Results CRVE tended to narrow with age. Mean CRVE was about 5 µm smaller (225 vs. 230 µm) for the average 70-year-old compared to the average 50-year-old, and was about 13 µm smaller (217 vs. 230 µm) for the average 85-year-old compared to the average 50-year-old. Male sex (beta estimate [β]=5.34; 95% confidence interval [CI] 3.58, 6.90), current smoking (β=9.38; 95% CI 8.26, 10.49), and higher white blood cell count (per 1000/µL: β=0.95; 95% CI 0.74, 1.16) were independently associated with larger concurrent CRVE while higher mean arterial blood pressure (per 5 mmHg: β=−0.36; 95% CI −0.50, −0.23) and higher high-density lipoprotein cholesterol (per 10 mg/dL: β=−0.89; 95% CI −1.15, −0.63) were independently associated with smaller concurrent CRVE. History of cardiovascular disease (β=−0.16; 95% CI −0.26, −0.06) and presence of chronic kidney disease (β=−0.20; 95% CI −0.34, −0.05) were associated with a greater decrease in CRVE over time. Conclusions These data show that retinal venular diameter tended to narrow with age, and that concurrent venular diameter is independently associated with sex, blood pressure, high-density lipoprotein cholesterol, white blood cell count, and current smoking, and change in CRVE is independently associated with a history of cardiovascular disease and presence of chronic kidney disease. The different independent effects of these interrelated factors on CRVE highlight the complex relationship between systemic diseases and conditions and CRVE, and the difficulty in determining specific causes of change in CRVE over time.

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Section: Discussionmentioning

confidence: 95%

Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

et al. 2012

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“…Neither antihypertensive medication use alone nor aspirin use alone was associated with wider retinal vessels. 36 It is possible that the systemic antiplatelet therapy combined with the antihypertensive medication administered immediately after the cerebrovascular event had vasodilatatory effects on retinal arterioles, leading to a not significantly reduced AVR in this study group compared with normotensive subjects. Measurements of arteriolar outer and lumen diameter performed by SLDF may consequently also be influenced by the treatment.…”

Section: Figurementioning

confidence: 96%

Wall-to-Lumen Ratio of Retinal Arterioles and Arteriole-to-Venule Ratio of Retinal Vessels in Patients with Cerebrovascular Damage

Baleanu

Ritt

Harazny

et al. 2009

Invest. Ophthalmol. Vis. Sci.

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“…Medication associations with vessel diameters may include not only those cardiovascular medications classified as vasodilators but may also include other blood pressure medications, systemic medications for other conditions, and herbal supplements. 16–18 Of particular interest are relatively new medications such as phosphodiesterase 5 inhibitors, angiotensin receptor blocking agents, and angiotensin converter enzyme agents as well as medications that act as anti-oxidants and others that have anti-inflammatory actions. 19,20 These medications have potential to alter RVDs as well as the associations of RVDs to cardiovascular disease.…”

mentioning

confidence: 99%

Cross-sectional Associations of Medication and Supplement Use With Retinal Vascular Diameter in the Beaver Dam Eye Study

et al. 2014

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IMPORTANCE Retinal vessel diameters are being measured to examine their relationship with ocular and systemic disease and, in some studies, to calculate the risk of disease. Important factors that directly affect retinal vessel diameters, such as medication use, should be considered when estimating these associations.OBJECTIVE To quantify the association between selected medications and supplements and retinal vessel diameters. DESIGN, SETTING, AND PARTICIPANTS In a prospective cohort investigation, 4926 participants (aged 43-86 years at baseline) in the Beaver Dam Eye Study were evaluated every 5 years during 20 years of follow-up from 1988 to 2010. MAIN OUTCOMES AND MEASURES Central retinal arteriolar equivalent and central retinal venular equivalent measured from the Early Treatment Diabetic Retinopathy Study fundus photograph field 1.RESULTS After Bonferroni correction, the use of any blood pressure medication (β = 0.75; P = .04), specifically calcium channel blockers (β = −1.02; P < .001), was significantly associated with wider central retinal arteriolar equivalent adjusting for refraction, photograph focus, age, systolic blood pressure, height, examination phase, educational level, smoking and drinking histories, and presence of diabetes mellitus and emphysema. Use of prostaglandin analogues was marginally associated with narrower central retinal arteriolar equivalent (β = −2.04; P = .09); β-blockers (β = −1.02; P = .10) and oral corticosteroids (β = 2.13; P = .07) were marginally associated with changes in the central retinal venular equivalent.CONCLUSIONS AND RELEVANCE Several medications are associated with central retinal arteriolar and venular equivalents. Prostaglandin analogues, calcium channel blockers, and oral corticosteroids have the largest relative effects. After Bonferroni correction was applied, the use of calcium channel blockers was most strongly associated with change in the central retinal arteriolar equivalent. The presence of factors that are associated with retinal vessel diameters should be considered when using retinal vessel diameter as an outcome or when using these measures to assess the risk of systemic or ocular disease.

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Regular aspirin use and retinal microvascular signs: the Blue Mountains Eye Study

Abstract: Our finding of a possible association between the combined use of aspirin and antihypertensive agent(s) and wider retinal arteriolar diameter warrants further investigation into the effects of aspirin on the microvasculature.

Cited by 18 publications

References 35 publications

Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

Wall-to-Lumen Ratio of Retinal Arterioles and Arteriole-to-Venule Ratio of Retinal Vessels in Patients with Cerebrovascular Damage

Cross-sectional Associations of Medication and Supplement Use With Retinal Vascular Diameter in the Beaver Dam Eye Study

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