title: Retinal vessel diameters and risk of hypertension: the Multiethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  To describe the prospective relationship of retinal vessel diameters with risk of hypertension in a multiethnic population-based cohort.
  
  
  METHODS
  The Multi-Ethnic Study of Atherosclerosis is a population-based study of subclinical cardiovascular disease among white, African-American, Hispanic, and Chinese American adults aged 45-84 years. Retinal vessel diameters were measured using a standardized imaging software at the second examination (considered baseline in this analysis) and summarized as the central retinal artery/vein equivalent. Presence of retinopathy and retinal focal arteriolar narrowing and arteriovenous nicking was assessed by trained graders. Incidence of hypertension was defined among participants at risk as systolic blood pressure at least 140 mmHg, diastolic blood pressure at least 90 mmHg, or use of an antihypertensive medication.
  
  
  RESULTS
  Of the initial 6237 participants at baseline, 2583 were at risk of hypertension. After 3.2 +/- 0.5 years of follow-up, 448 (17.3%) participants developed hypertension. After adjusting for age, sex, race/ethnicity, the average of mean arterial blood pressure in the first and second examination, and other vascular risk factors, persons with narrower retinal arteriolar diameter and wider venular diameter at baseline were more likely to develop hypertension [odds ratio per SD decrease in central retinal artery equivalent 1.20, 95% confidence intervals 1.02, 1.42; and odds ratio per SD increase in central retinal vein equivalent 1.18, 95% confidence interval 1.02, 1.37]. Persons with focal arteriolar narrowing were also more likely to develop hypertension (odds ratio 1.80, 95% confidence interval 1.09, 2.97).
  
  
  CONCLUSIONS
  Findings from this multiethnic population confirm that narrower retinal arteriolar diameter and wider venular diameter are associated with the development of hypertension independent of traditional risk factors.
authors.affiliation: Department of Ophthalmology, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Ning
authors.initials: N
authors.lastname: Cheung
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara Ek
authors.initials: BE
authors.lastname: Klein
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Cotch
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Fm Amirul
authors.initials: FA
authors.lastname: Islam
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D002196:Capillaries / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012164:Retinal Diseases / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D012171:Retinal Vessels / Q000473:pathology*; D018570:Risk Assessment; D014481:United States / Q000208:ethnology; D014661:Vasoconstriction / Q000502:physiology
references.citation: J Hypertens. 2008 Aug;26(8):1703-7
references.pmid: 18622251
references.citation: Arch Ophthalmol. 2006 Jan;124(1):87-94
references.pmid: 16401789
references.citation: Lancet. 2007 Feb 3;369(9559):425-35
references.pmid: 17276782
references.citation: Invest Ophthalmol Vis Sci. 2008 Apr;49(4):1362-6
references.pmid: 18385051
references.citation: Curr Eye Res. 2003 Sep;27(3):143-9
references.pmid: 14562179
references.citation: Ann Neurol. 2007 Dec;62(6):618-24
references.pmid: 17918248
references.citation: Hypertension. 2006 Dec;48(6):1012-7
references.pmid: 17060505
references.citation: Am J Ophthalmol. 2006 Mar;141(3):446-455
references.pmid: 16490489
references.citation: Hypertension. 2007 Oct;50(4):617-22
references.pmid: 17698721
references.citation: Am J Hypertens. 1994 Feb;7(2):193-200
references.pmid: 8179854
references.citation: Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2341-50
references.pmid: 16723443
references.citation: Ann Intern Med. 2004 Feb 17;140(4):248-55
references.pmid: 14970147
references.citation: Ophthalmology. 1991 May;98(5 Suppl):786-806
references.pmid: 2062513
references.citation: N Engl J Med. 2004 Nov 25;351(22):2310-7
references.pmid: 15564546
references.citation: Ophthalmology. 2006 Mar;113(3):373-80
references.pmid: 16513455
references.citation: Hypertension. 2003 May;41(5):1086-91
references.pmid: 12654714
references.citation: Hypertension. 2006 Feb;47(2):189-94
references.pmid: 16380526
references.citation: Am J Epidemiol. 2008 Jul 1;168(1):80-8
references.pmid: 18469315
references.citation: Hypertension. 2004 Oct;44(4):442-7
references.pmid: 15302843
references.citation: Physiol Rev. 1982 Apr;62(2):347-504
references.pmid: 6461865
references.citation: BMJ. 2004 Jul 10;329(7457):79
references.pmid: 15175230
references.citation: Am J Hypertens. 2004 Oct;17(10):963-70
references.pmid: 15485761
references.citation: Am J Epidemiol. 2002 Nov 1;156(9):871-81
references.pmid: 12397006
references.citation: Hypertension. 2003 Dec;42(6):1206-52
references.pmid: 14656957
references.citation: Ophthalmology. 1999 Dec;106(12):2269-80
references.pmid: 10599656
references.citation: Br J Ophthalmol. 2008 Feb;92(2):161-6
references.pmid: 17965107
references.citation: Trans Am Ophthalmol Soc. 2006;104:98-107
references.pmid: 17471330
references.citation: Circulation. 2001 Aug 7;104(6):735-40
references.pmid: 11489784
references.citation: Hypertension. 1991 Sep;18(3 Suppl):I52-7
references.pmid: 1889858
references.citation: Circulation. 2005 Mar 15;111(10):1313-20
references.pmid: 15769774
references.citation: Hypertension. 2006 Aug;48(2):e10; author reply e11
references.pmid: 16801487
references.citation: Hypertension. 2006 May;47(5):e19; author reply e19
references.pmid: 16585407
references.citation: Am J Cardiol. 2005 Oct 1;96(7):956-63
references.pmid: 16188524
references.citation: Invest Ophthalmol Vis Sci. 2004 Sep;45(9):2949-54
references.pmid: 15326106
references.citation: J Hypertens Suppl. 1992 Jul;10(5):S59-68
references.pmid: 1403235
references.citation: Hypertension. 1994 Sep;24(3):301-8
references.pmid: 8082936
references.citation: Circulation. 2008 Aug 26;118(9):968-76
references.pmid: 18725503
references.citation: J Am Coll Cardiol. 2007 Jul 3;50(1):48-55
references.pmid: 17601545