Related Experiment Video
Updated: Aug 26, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Relationship between carotid artery stiffness and retinal arteriolar narrowing in healthy middle-aged persons
Duanping Liao1, Tien Yin Wong, Ronald Klein
1Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, A210, 600 Centerview Dr, Hershey, PA 17033, USA. DLiao@psu.edu
Insights
Stiffer carotid arteries are linked to narrower retinal arterioles in healthy adults, suggesting a connection between large and small blood vessel diseases that may impact stroke risk.
Area of Science:
- Vascular biology
- Cardiovascular research
- Ophthalmology
Background:
- Carotid atherosclerosis and cerebral arteriolosclerosis are known stroke risk factors.
- The relationship between macrovascular (carotid) and microvascular (cerebral) disease is not well understood.
Purpose of the Study:
- To investigate the association between carotid artery stiffness and retinal arteriolar narrowing in healthy middle-aged individuals.
- To explore the link between macrovascular atherosclerosis and microvascular arteriolosclerosis.
Main Methods:
- Cross-sectional study of 8031 adults aged 45-64.
- Carotid artery stiffness measured using ultrasonic echo tracking (adjusted arterial diameter change - AADC).
- Retinal arteriolar narrowing assessed via retinal photographs (arteriole-to-venule ratio - AVR).
Main Results:
- Decreased AADC (greater stiffness) was significantly associated with decreased AVR (greater narrowing).
- This association remained significant after adjusting for age, sex, ethnicity, hypertension, diabetes, and smoking.
- The relationship was consistent in individuals with and without hypertension.
Conclusions:
- Increased carotid artery stiffness correlates with generalized retinal arteriolar narrowing.
- This finding supports a link between macrovascular and microvascular disease processes in stroke pathogenesis.
- The association is independent of common vascular risk factors like blood pressure.
Background And Purpose:
Both carotid atherosclerosis and cerebral arteriolosclerosis are associated with stroke. However, the relationship between carotid atherosclerosis and cerebral arteriolosclerosis is unknown. We examined the association between carotid artery stiffness, a marker of early atherosclerosis, and retinal arteriolar narrowing, a marker of arteriolosclerosis, in healthy middle-aged people.
Methods:
This population-based, cross-sectional study involved 8031 men and women 45 to 64 years of age. Carotid arterial stiffness was estimated from high-resolution ultrasonic echo tracking of the left common carotid artery and was defined as adjusted arterial diameter change (AADC, micro, adjusted for diastolic blood pressure, pulse pressure and pulse pressure squared, and diastolic arterial diameter and height, with smaller AADC reflecting greater arterial stiffness). Generalized retinal arteriolar narrowing was estimated from measurements of diameters of retinal vessels from digitized retinal photographs and summarized as the arteriole-to-venule ratio (AVR, with smaller AVR indicating greater retinal arteriolar narrowing).
Results:
After controlling for age, sex, ethnicity, hypertension, diabetes, and cigarette smoking, decreasing AADC was associated with decreasing AVR. The mean AADCs, comparing the lowest and highest quartiles of AVR, were 394 (SE, 4) and 409 (SE, 4) micro, respectively (P<0.01). The pattern of the graded association between carotid arterial stiffness and generalized retinal arteriolar narrowing was similar among persons with and without hypertension.
Conclusions:
Greater stiffness of the carotid arteries is related to generalized narrowing of the retinal arterioles independent of blood pressure and other vascular factors. This supports a relationship between macrovascular and microvascular disease processes important in stroke pathogenesis.
