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Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study.

Publication ,  Journal Article
Wong, TY; Klein, R; Sharrett, AR; Duncan, BB; Couper, DJ; Tielsch, JM; Klein, BEK; Hubbard, LD
Published in: JAMA
March 6, 2002

CONTEXT: 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. OBJECTIVE: 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. DESIGN, SETTING, AND PARTICIPANTS: 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. MAIN OUTCOME MEASURE: Risk of CHD associated with retinal arteriolar narrowing. RESULTS: 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). CONCLUSION: 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.

Duke Scholars

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

March 6, 2002

Volume

287

Issue

9

Start / End Page

1153 / 1159

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Retinal Vessels
  • Retinal Diseases
  • Prospective Studies
  • Proportional Hazards Models
  • Photography
  • Middle Aged
  • Male
  • Image Processing, Computer-Assisted
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wong, T. Y., Klein, R., Sharrett, A. R., Duncan, B. B., Couper, D. J., Tielsch, J. M., … Hubbard, L. D. (2002). Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. JAMA, 287(9), 1153–1159. https://doi.org/10.1001/jama.287.9.1153
Wong, Tien Yin, Ronald Klein, A Richey Sharrett, Bruce B. Duncan, David J. Couper, James M. Tielsch, Barbara E. K. Klein, and Larry D. Hubbard. “Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study.JAMA 287, no. 9 (March 6, 2002): 1153–59. https://doi.org/10.1001/jama.287.9.1153.
Wong TY, Klein R, Sharrett AR, Duncan BB, Couper DJ, Tielsch JM, et al. Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. JAMA. 2002 Mar 6;287(9):1153–9.
Wong, Tien Yin, et al. “Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study.JAMA, vol. 287, no. 9, Mar. 2002, pp. 1153–59. Pubmed, doi:10.1001/jama.287.9.1153.
Wong TY, Klein R, Sharrett AR, Duncan BB, Couper DJ, Tielsch JM, Klein BEK, Hubbard LD. Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. JAMA. 2002 Mar 6;287(9):1153–1159.
Journal cover image

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

March 6, 2002

Volume

287

Issue

9

Start / End Page

1153 / 1159

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Retinal Vessels
  • Retinal Diseases
  • Prospective Studies
  • Proportional Hazards Models
  • Photography
  • Middle Aged
  • Male
  • Image Processing, Computer-Assisted