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Aortic distensibility and retinal arteriolar narrowing: the multi-ethnic study of atherosclerosis
Ning Cheung1, A Richey Sharrett, Ronald Klein
1Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
Insights
Increased aortic stiffness, a sign of hypertension, is linked to retinal arteriolar narrowing. This finding suggests microvascular changes may connect aortic stiffness to cardiovascular events.
Area of Science:
- Cardiovascular Science
- Ophthalmology
- Hypertension Research
Background:
- Chronic hypertension causes subclinical vascular damage, including increased aortic stiffness and retinal arteriolar narrowing.
- These vascular changes are known predictors of future cardiovascular events.
- The precise relationship between aortic stiffness and retinal arteriolar narrowing remains unclear.
Purpose of the Study:
- To investigate the association between aortic distensibility and retinal arteriolar caliber in a large, multi-ethnic cohort.
- To determine if aortic stiffness is independently associated with retinal arteriolar narrowing, beyond blood pressure and other risk factors.
Main Methods:
- Cross-sectional analysis of 3425 participants (aged 45-85) from the Multi-Ethnic Study of Atherosclerosis, free of clinical cardiovascular disease.
- Retinal vascular caliber quantified from digital retinal photographs; aortic distensibility measured via chest MRI.
- Statistical models controlled for numerous demographic, clinical, and biochemical variables.
Main Results:
- Reduced aortic distensibility was significantly associated with increased odds of retinal arteriolar narrowing (OR: 1.72; 95% CI: 1.15-2.58).
- This association persisted after adjusting for traditional cardiovascular risk factors and atherosclerotic measures.
- No association was found between aortic distensibility and retinal venular caliber.
Conclusions:
- Increased aortic stiffness is independently associated with retinal arteriolar narrowing.
- These findings suggest that microvascular alterations in the retina may contribute to the link between aortic stiffness and cardiovascular events.
- Aortic stiffness may serve as a marker for broader vascular dysfunction.
Abstract:
Increased aortic stiffness and retinal arteriolar narrowing are subclinical vascular effects of chronic hypertension and predict future cardiovascular events. The relationship between these 2 vascular measures is uncertain and is examined in the Multi-Ethnic Study of Atherosclerosis. This cross-sectional analysis involves 3425 participants (aged 45 to 85 years) free of clinical cardiovascular disease. Retinal vascular caliber was quantified from digital retinal photographs using standardized protocols. Aortic distensibility was determined from chest MRI. After controlling for age, squared age, gender, race, study center, height, weight, heart rate, cigarette smoking, past and current systolic blood pressure, use of antihypertensive medications, diabetes, fasting glucose, lipid profile, and C-reactive protein, reduced aortic distensibility (first versus fourth distensibility quartile) was associated with increased odds of retinal arteriolar narrowing (odds ratio: 1.72; 95% CI: 1.15 to 2.58, comparing lowest to highest quartile of arteriolar caliber). Further adjustments for atherosclerotic measures (carotid intima-media thickness, coronary calcium score, and ankle brachial index) had minimal impact on this association (odds ratio: 1.70; 95% CI: 1.13 to 2.55). Reduced aortic distensibility was not associated with retinal venular caliber. We conclude that increased aortic stiffness is associated with retinal arteriolar narrowing, independent of measured blood pressure levels and vascular risk factors. These data suggest that changes in the microvasculature may play a role linking aortic stiffness with clinical cardiovascular events.
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