Joint Effect of Early Microvascular Damage in the Eye &Kidney on Risk of Cardiovascular Events.
Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD), but not all individuals require treatment. Retinal microvascular abnormalities and microalbuminuria reflect early systemic microvascular changes. We examined the joint effect of retinal abnormalities and microalbuminuria on CVD risk in an Asian cohort. We conducted a prospective, population-based study. Retinal abnormalities were defined as presence of retinopathy and/or retinal venular widening. Microalbuminuria was defined as urinary albumin: creatinine ratio between 30-300 mg/g. Incident CVD was defined as newly diagnosed clinical stroke, acute myocardial infarction or CVD death. Cox regression models were performed to determine the associations between retinal abnormalities and microalbuminuria with risk of CVD, while controlling for established risk factors. 3,496 participants (aged ≥ 40) were free of prevalent CVD. During the follow-up (5.8 years), 126 (3.60%) participants developed CVD. Persons presenting with both retinal abnormalities and microalbuminuria were 6.71 times (95% CI, 2.68, 16.79) as likely to have incident CVD compared with those without either abnormalities. There was a significant interaction effect between retinal abnormalities and microalbuminuria on incident CVD. Assessment of retinal abnormalities in patients with microalbuminuria may provide additional value in identifying persons at risk of developing CVD.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Wanfen
W
Yip
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
Charumathi
C
Sabanayagam
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Peng Guan
PG
Ong
Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Uptal D
UD
Patel
Khuan Yew
KY
Chow
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
E Shyong
ES
Tai
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Cardiac Department, National University Heart Centre, Singapore.
Lieng H
LH
Ling
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
Tien Yin
TY
Wong
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Carol Yim-Lui
CY
Cheung
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D012307:Risk Factors