title: Retinal microvasculature and cardiovascular health in childhood.
abstract: OBJECTIVE
  Alterations in retinal microvasculature are associated with increased risk of cardiovascular disease. We examined the associations of retinal vessel caliber with cardiovascular markers in school-age children.
  
  
  METHODS
  Among 4007 school-age children (median age of 6.0 years), we measured cardiovascular markers and retinal vessel calibers from digitized retinal photographs.
  
  
  RESULTS
  Narrower retinal arteriolar caliber was associated with higher systolic and diastolic blood pressure (-0.20 SD score [SDS] [95% confidence interval (CI) -0.24 to -0.18] and -0.14 SDS [-0.17 to -0.11], respectively, per SDS increase in retinal arteriolar caliber), mean arterial pressure, and pulse pressure, but not with carotid-femoral pulse wave velocity, heart rate, cardiac output, or left ventricular mass. A wider retinal venular caliber was associated with lower systolic blood pressure, mean arterial pressure, and pulse pressure and higher carotid-femoral pulse wave velocity (carotid-femoral pulse wave velocity difference = 0.04 SDS [95% CI 0.01 to 0.07] per SDS increase in retinal venular caliber). Both narrower retinal arteriolar and venular calibers were associated with higher risk of hypertension at the age of 6 years, with the strongest association for retinal arteriolar caliber (odds ratio 1.35 [95% CI 1.21 to 1.45] per SDS decrease in arteriolar caliber). Adjustment for parental and infant sociodemographic factors did not influence the observed associations.
  
  
  CONCLUSIONS
  Both retinal arteriolar and venular calibers are associated with blood pressure in school-age children, whereas retinal venular caliber is associated with carotid-femoral pulse wave velocity. Microvascular adaptations in childhood might influence cardiovascular health and disease from childhood onward.
authors.affiliation: The Generation R Study Group, Department of Pediatrics, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
authors.forename: Olta
authors.initials: O
authors.lastname: Gishti
authors.affiliation: The Generation R Study Group, Department of Pediatrics, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands; v.jaddoe@erasmusmc.nl.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: The Generation R Study Group, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
authors.forename: Janine F
authors.initials: JF
authors.lastname: Felix
authors.affiliation: Department of Ophthalmology, and.
authors.forename: Caroline C W
authors.initials: CC
authors.lastname: Klaver
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Singapore Eye Research Institute, Singapore; and Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore; and Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Mohammad Kamran
authors.initials: MK
authors.lastname: Ikram
authors.affiliation: The Generation R Study Group, Department of Pediatrics, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
authors.forename: Romy
authors.initials: R
authors.lastname: Gaillard
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology*; D009426:Netherlands; D063177:Pulse Wave Analysis; D012016:Reference Values; D012171:Retinal Vessels / Q000473:pathology*; D018570:Risk Assessment; D013223:Statistics as Topic; D014654:Vascular Patency / Q000502:physiology*