Meta-analysis: retinal vessel caliber and risk for coronary heart disease.
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.
McGeechan
Kevin
K
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Liew
Gerald
G
Macaskill
Petra
P
Irwig
Les
L
Klein
Ronald
R
Klein
Barbara E K
BE
Wang
Jie Jin
JJ
Mitchell
Paul
P
Vingerling
Johannes R
JR
Dejong
Paulus T V M
PT
Witteman
Jacqueline C M
JC
Breteler
Monique M B
MM
Shaw
Jonathan
J
Zimmet
Paul
P
Wong
Tien Y
TY
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
D015415:Biomarkers