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Central arterial stiffness and retinal vessel calibers: the Atherosclerosis Risk in Communities Study-Neurocognitive
Michelle L Meyer1, Barbara E Klein2, Ronald Klein2
1Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Insights
Central arterial stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), was linked to wider retinal venules in older adults, especially those without hypertension. This suggests arterial stiffening may impact cerebral microvasculature.
Area of Science:
- Ophthalmology
- Cardiology
- Neurology
Background:
- The retinal microvasculature offers insights into cerebral vasculature.
- Changes in retinal caliber may reflect cerebrovascular disease.
- The link between central arterial stiffness and retinal vessel caliber is not fully understood.
Purpose of the Study:
- To examine the association between central arterial stiffness and retinal vessel caliber in older adults.
- To investigate if this association differs based on hypertension or type 2 diabetes status.
Main Methods:
- Cross-sectional study of 1706 older adults from the Atherosclerosis Risk in Communities Study.
- Measured central arterial stiffness using carotid-femoral pulse wave velocity (cfPWV).
- Assessed retinal vessel calibers (central retinal arteriolar equivalent and central retinal vein equivalent).
Main Results:
- Carotid-femoral PWV was not associated with narrower retinal arterioles.
- cfPWV was associated with wider retinal venules, particularly in individuals without hypertension.
- The association was slightly stronger in those with type 2 diabetes.
Conclusions:
- Central arterial stiffness is associated with wider retinal venular caliber in older adults, especially those without hypertension.
- Arterial stiffening may be linked to microvascular changes in the brain, as indicated by the retinal vasculature.
Background:
The retinal microvasculature provides a window to the cerebral vasculature and enables examination of changes in retinal caliber that may mimic those occurring in cerebrovascular disease. The association of central arterial stiffness and retinal vessel caliber in a population sample is not fully understood.
Methods:
In 1706 older adults (mean age 76.3, 58.1% women) from the population-based Atherosclerosis Risk in Communities Study, we examined the cross-sectional association of central arterial stiffness [carotid-femoral pulse wave velocity (cfPWV)] with retinal vessel calibers [central retinal arteriolar equivalent (CRAE) and central retinal vein equivalent (CRVE)]. We estimated the association of cfPWV with CRAE narrowing (<25th percentile) and CRVE widening (>75th percentile) after adjustment for age, sex, race-field center, BMI, smoking, and type 2 diabetes. We tested for effect modification by sex, hypertension, and type 2 diabetes.
Results:
Carotid-femoral PWV (m/s) was not associated with the odds of CRAE narrowing [odds ratio (OR): 0.99; 95% CI: 0.95-1.03]. The association of cfPWV with CRVE widening was stronger in those without hypertension (OR: 1.10; 95% CI: 1.01-1.20) versus those with hypertension (OR: 1.01 95% CI: 0.96-1.05) and slightly stronger in those with type 2 diabetes (OR: 1.07; 95% CI: 1.00-1.14) versus without type 2 diabetes (OR: 1.01; 95% CI: 0.96-1.06).
Conclusions:
In older adults, cfPWV was associated with wider retinal venular caliber, particularly in individuals without hypertension. Central arterial stiffening may be associated with cerebral microvascular changes, as exhibited in its retinal vasculature component.
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