Association of retinal vessel calibers and longitudinal changes in arterial stiffness: the Nagahama study

Morphological change in retinal vessel calibers has been reported as a marker of cardiovascular risk, but its association with arterial stiffening, a possible factor relating retinal vessel sings and cardiovascular outcomes, is not clear. The study aim was to clarify the relationship between retinal small vessel calibers and longitudinal change in large arterial stiffness in a sample of the general population.

The study included 6720 Japanese participants (52.1 ± 12.8 years). Central retinal arteriolar equivalent (CRAE) and venular equivalent were measured by fundus photography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV) at baseline and at 5 years.

The overall change in baPWV (ΔbaPWV) during a mean follow-up 1814 ± 136 days was 41 ± 131 cm/s (3.4 ± 9.9%), and was significantly increased in individuals with narrower CRAE (quartiles: Q1, 4.3 ± 10.6%; Q2, 3.3 ± 10.0%; Q3, 3.1 ± 9.3%; Q4, 3.1 ± 9.7%, P = 0.001). No significant association was observed with central retinal venular equivalent. Multivariate analysis identified CRAE as a significant inverse determinant of ΔbaPWV (β = -0.033, P = 0.006) independent of possible covariates including age, sex, blood pressure, and baseline baPWV. The association between CRAE and ΔbaPWV was prominent in a middle-aged (age Q2, β = -0.078, P = 0.002), but not younger (Q1, P = 0.232) or older (Q3, P = 0.427; Q4, P = 0.542) participants.

Narrower CRAE in middle-age was associated with the long-term risk of arteriosclerosis in a general population sample.