title: Meta-analysis: retinal vessel caliber and risk for coronary heart disease.
abstract: BACKGROUND
  Retinal vessel caliber may be a novel marker of coronary heart disease (CHD) risk. However, the sex-specific effect, magnitude of association, and effect independent of traditional CHD disease risk factors remain unclear.
  
  
  OBJECTIVE
  To determine the association between retinal vessel caliber and risk for CHD.
  
  
  METHODS
  Relevant studies in any language identified through MEDLINE (1950 to June 2009) and EMBASE (1950 to June 2009) databases.
  
  
  METHODS
  Studies were included if they examined a general population, measured retinal vessel caliber from retinal photographs, and documented CHD risk factors and incident CHD events.
  
  
  METHODS
  6 population-based prospective cohort studies provided data for individual participant meta-analysis.
  
  
  RESULTS
  Proportional hazards models, adjusted for traditional CHD risk factors, were constructed for retinal vessel caliber and incident CHD in women and men. Among 22,159 participants who were free of CHD and followed for 5 to 14 years, 2219 (10.0%) incident CHD events occurred. Retinal vessel caliber changes (wider venules and narrower arterioles) were each associated with an increased risk for CHD in women (pooled multivariable-adjusted hazard ratios, 1.16 [95% CI, 1.06 to 1.26] per 20-microm increase in venular caliber and 1.17 [CI, 1.07 to 1.28] per 20-microm decrease in arteriolar caliber) but not in men (1.02 [CI, 0.94 to 1.10] per 20-microm increase in venular caliber and 1.02 [CI, 0.95 to 1.10] per 20-microm decrease in arteriolar caliber). Women without hypertension or diabetes had higher hazard ratios.
  
  
  CONCLUSIONS
  Error in the measurement of retinal vessel caliber and Framingham variables was not taken into account.
  
  
  CONCLUSIONS
  Retinal vessel caliber changes were independently associated with an increased risk for CHD events in women.
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: McGeechan
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.forename: Petra
authors.initials: P
authors.lastname: Macaskill
authors.forename: Les
authors.initials: L
authors.lastname: Irwig
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Vingerling
authors.forename: Paulus T V M
authors.initials: PT
authors.lastname: Dejong
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaw
authors.forename: Paul
authors.initials: P
authors.lastname: Zimmet
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D001160:Arterioles / Q000473:pathology; D015415:Biomarkers; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D012737:Sex Factors; D014699:Venules / Q000473:pathology
chemical_list: D015415:Biomarkers