Retinal vessel diameters and risk of hypertension: the Multiethnic Study of Atherosclerosis.
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.
Kawasaki
Ryo
R
Department of Ophthalmology, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
Cheung
Ning
N
Wang
Jie Jin
JJ
Klein
Ronald
R
Klein
Barbara Ek
BE
Cotch
Mary Frances
MF
Sharrett
A Richey
AR
Shea
Steven
S
Islam
Fm Amirul
FA
Wong
Tien Y
TY
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
J Hypertens. 2008 Aug;26(8):1703-7
18622251
Arch Ophthalmol. 2006 Jan;124(1):87-94
16401789
Lancet. 2007 Feb 3;369(9559):425-35
17276782
Invest Ophthalmol Vis Sci. 2008 Apr;49(4):1362-6
18385051
Curr Eye Res. 2003 Sep;27(3):143-9
14562179
Ann Neurol. 2007 Dec;62(6):618-24
17918248
Hypertension. 2006 Dec;48(6):1012-7
17060505
Am J Ophthalmol. 2006 Mar;141(3):446-455
16490489
Hypertension. 2007 Oct;50(4):617-22
17698721
Am J Hypertens. 1994 Feb;7(2):193-200
8179854
Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2341-50
16723443
Ann Intern Med. 2004 Feb 17;140(4):248-55
14970147
Ophthalmology. 1991 May;98(5 Suppl):786-806
2062513
N Engl J Med. 2004 Nov 25;351(22):2310-7
15564546
Ophthalmology. 2006 Mar;113(3):373-80
16513455
Hypertension. 2003 May;41(5):1086-91
12654714
Hypertension. 2006 Feb;47(2):189-94
16380526
Am J Epidemiol. 2008 Jul 1;168(1):80-8
18469315
Hypertension. 2004 Oct;44(4):442-7
15302843
Physiol Rev. 1982 Apr;62(2):347-504
6461865
BMJ. 2004 Jul 10;329(7457):79
15175230
Am J Hypertens. 2004 Oct;17(10):963-70
15485761
Am J Epidemiol. 2002 Nov 1;156(9):871-81
12397006
Hypertension. 2003 Dec;42(6):1206-52
14656957
Ophthalmology. 1999 Dec;106(12):2269-80
10599656
Br J Ophthalmol. 2008 Feb;92(2):161-6
17965107
Trans Am Ophthalmol Soc. 2006;104:98-107
17471330
Circulation. 2001 Aug 7;104(6):735-40
11489784
Hypertension. 1991 Sep;18(3 Suppl):I52-7
1889858
Circulation. 2005 Mar 15;111(10):1313-20
15769774
Hypertension. 2006 Aug;48(2):e10; author reply e11
16801487
Hypertension. 2006 May;47(5):e19; author reply e19
16585407
Am J Cardiol. 2005 Oct 1;96(7):956-63
16188524
Invest Ophthalmol Vis Sci. 2004 Sep;45(9):2949-54
15326106
J Hypertens Suppl. 1992 Jul;10(5):S59-68
1403235
Hypertension. 1994 Sep;24(3):301-8
8082936
Circulation. 2008 Aug 26;118(9):968-76
18725503
J Am Coll Cardiol. 2007 Jul 3;50(1):48-55
17601545