title: Association of ideal cardiovascular health metrics and retinal microvascular findings: the Atherosclerosis Risk in Communities Study.
abstract: BACKGROUND
  This study evaluated the prevalence of ideal cardiovascular (CV) health in the Atherosclerosis Risk in Communities Study and determined its relationship with prevalent retinopathy, wider retinal venular diameters, and narrower arteriolar diameters, which are risk markers for subclinical cerebrovascular disease and are associated with increased stroke and coronary heart disease (CHD) morbidity and mortality.
  
  
  RESULTS
  We used gradings of fundus photography measurements from the Atherosclerosis Risk in Communities Study to examine the association of retinopathy and retinal arteriolar and venular calibers to the number of ideal CV health metrics. Prevalent retinopathy showed a graded relationship with the CV health categories and number of ideal CV health metrics present: retinopathy prevalence was 2.1% among those with ≥5 ideal CV health metrics compared with 13.1% among those with zero ideal CV health metrics (odds ratio [CI]), 4.8 [2.5 to 8.9]). Central retinal venule equivalent and central retinal arteriolar equivalent diameters also showed graded relationships with CV health categories and number of ideal CV health metrics: after adjustment for age, race, sex, and education, mean central retinal venular equivalent was 187.8 μm (95% CI, 186.9 to 188.6 μm) among those with ≥5 ideal CV health metrics compared with 201.1 μm (95% CI, 199.1 to 203.1 μm) among those with zero ideal CV health metrics. Mean central retinal arteriolar equivalent was 163.8 μm (95% CI, 163.0 to 164.5 μm) among those with ≥5 ideal CV health metrics compared with 157.9 μm (95% CI, 156.1 to 159.7 μm) among those with zero ideal CV health metrics.
  
  
  CONCLUSIONS
  Few adults had ideal cardiovascular health. Those with the best level of health were less likely to have retinopathy signs, wide retinal venules, and narrow retinal arterioles, which are associated with increased stroke and coronary heart disease risk.
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: Ejovwoke R
authors.initials: ER
authors.lastname: Ogagarue
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Klein
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
mesh_terms: D001160:Arterioles / Q000473:pathology; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012164:Retinal Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014699:Venules / Q000473:pathology
chemical_list: D015415:Biomarkers
keywords: cardiovascular diseases; cardiovascular health metrics; cerebrovascular circulation; epidemiology; risk factors