Retinal Vascular Caliber, Cardiovascular Risk Factors, and Inflammation: The Multi-Ethnic Study of Atherosclerosis (MESA)
Investigative Ophthalmology & Visual SciencePublished 24 May 2006Open access
Tien Yin Wong, Amirul Islam, Ronald Klein, Ronald Klein, Mary Frances Cotch, Cecilia Castro
Citations605
SJR quartileQ4
SJR score0.11
SNIP0.06
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Retinal arteriolar and venular caliber is associated with a range of cardiovascular risk factors, including hypertension, diabetes, measures of obesity, and dyslipidemia and is also associated with systemic inflammation.
Abstract
Retinal arteriolar and venular caliber is associated with a range of cardiovascular risk factors, including hypertension, diabetes, measures of obesity, and dyslipidemia. Venular caliber is also associated with systemic inflammation.
Keywords
Medicine
NatureInflammation in atherosclerosis
8,172 Citations2002Peter Libby
The new appreciation of the role of inflammation in atherosclerosis provides a mechanistic framework for understanding the clinical benefits of lipid-lowering therapies and unravelling the details of inflammatory pathways may eventually furnish new therapeutic targets.
New England Journal of MedicineAcute-Phase Proteins and Other Systemic Responses to Inflammation
6,709 Citations1999Cem Gabay, Irving Kushner
A large number of changes, distant from the site or sites of inflammation and involving many organ systems, may accompany inflammation, and the mechanisms mediating them are becoming better understood.
American Journal of EpidemiologyMulti-Ethnic Study of Atherosclerosis: Objectives and Design
3,958 Citations2002Diane E. Bild
The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years for identification and characterization of CVD events.
Arteriosclerosis Thrombosis and Vascular BiologyInflammation in Atherosclerosis
3,712 Citations2012Peter Libby
The discovery of the immune basis of allograft arteriosclerosis demonstrated that inflammation per se can drive arterial hyperplasia, even in the absence of traditional risk factors.
Annals of EpidemiologyThe cardiovascular health study: Design and rationale
3,638 Citations1991Linda P. Fried, Nemat O. Borhani +13 more
These examinations in CHS permit evaluation of CVD risk factors in older adults, particularly in groups previously under-represented in epidemiologic studies, such as women and the very old.
PubMedGrading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group.
1,244 Citations1991
The modified Airlie House classification of diabetic retinopathy has been extended and its reproducibility between graders is assessed by calculating percentages of agreement and kappa statistics for duplicate gradings of baseline color nonsimultaneous stereoscopic fundus photographs.
OphthalmologyMethods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the atherosclerosis risk in communities study11The authors have no proprietary interest in the equipment and techniques described in this article.
1,166 Citations1999Larry D. Hubbard, Rosemary J. Brothers +7 more
Protocols have been developed for nonmydriatic fundus photography and for evaluation of retinal vascular abnormalities in the ARIC Study and several microvascular changes were significantly associated with higher blood pressure, controlling for gender, race, age, and smoking status.
Current Eye ResearchRevised formulas for summarizing retinal vessel diameters
850 Citations2003Michael D. Knudtson, Kristine E. Lee +4 more
Revised formulas for summarizing retinal vessel diameters measured from fundus photographs are described, which offer the advantages of being more robust against variability in the number of vessels observed, being independent of image scale, and being easier to implement.
JAMARetinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women
777 Citations2002Tien Yin Wong, Ronald Klein +6 more
Retinal arteriolar narrowing is related to risk of CHD in women but not in men, supporting a more prominent microvascular role in the development of CHd in women than in men.
The LancetRetinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study
760 Citations2001Tien Yin Wong, Ronald Klein +6 more
Most retinal microvascular characteristics were predictive of incident stroke, and the associations were similar for ischaemic strokes specifically, and for strokes in individuals with hypertension, either with or without diabetes.
CirculationEthnic Differences in Coronary Calcification
743 Citations2005Diane E. Bild, Robert Detrano +7 more
Ethnic differences in the presence and quantity of coronary calcification that were not explained by coronary risk factors are observed.
Current Opinion in LipidologyObesity, adiponectin and vascular inflammatory disease
732 Citations2003Noriyuki Ouchi, Shinji Kihara +3 more
Adiponectin is an endogenous biologically relevant modulator of vascular remodeling linking obesity and vascular disease, and acts as an anti-inflammatory and anti-atherogenic plasma protein.
American Journal of OphthalmologyDiabetic Retinopathy in a Multi-ethnic Cohort in the United States
694 Citations2006Tien Yin Wong, Ronald Klein +6 more
This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.
New England Journal of MedicineHypertensive Retinopathy
669 Citations2004Tien Yin Wong, Paul Mitchell
CirculationMicrocirculation in Hypertension
622 Citations2001Bernard Lévy, Giuseppe Ambrosio +2 more
The number of effective agents available for the treatment of hypertension is now substantial, but the great majority of hypertensive subjects still show imperfect blood pressure control.
Survey of OphthalmologyRetinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality
614 Citations2001Tien Yin Wong, Ronald Klein +4 more
There is no convincing evidence of an independent or direct association with atherosclerosis, ischemic heart disease, or cardiovascular mortality, but when reliably quantified, retinal microvascular abnormalities may be useful as risk indicators for cerebrovascular diseases.
PubMedEnd-stage renal disease in African-American and white men. 16-year MRFIT findings.
588 Citations1997Michael J. Klag, P K Whelton +4 more
Investigative Ophthalmology & Visual ScienceAre Retinal Arteriolar or Venular Diameters Associated with Markers for Cardiovascular Disorders? The Rotterdam Study
497 Citations2004M. Kamran Ikram, Frank Jan de Jong +5 more
Associations between retinal arteriolar and venular diameters, and the AVR on the one hand and blood pressure, atherosclerosis, inflammation markers, and cholesterol levels on the other were examined in the Rotterdam Study indicate that retinal venULAR diameters are variable and may play their own independent role in predicting cardiovascular disorders.
OphthalmologyComputer-assisted measurement of retinal vessel diameters in the Beaver Dam Eye Study*1methodology, correlation between eyes, and effect of refractive errors
446 Citations2004Tien Yin Wong
The data suggest that measurement of retinal vessel diameters from one eye without regard to its refractive status may provide adequate information indicative of a person's retinal vessels caliber if information from two eyes and refraction is unavailable.
OphthalmologyPrevalence of Age-Related Macular Degeneration in 4 Racial/Ethnic Groups in the Multi-ethnic Study of Atherosclerosis
394 Citations2006Ronald Klein, Ronald Klein +7 more
Low prevalences of AMD were found in the MESA cohort in all groups, and a lower prevalence was found in blacks compared with whites, while the higher prevalence of exudative AMD in Chinese needs further study.
American Journal of EpidemiologyRetinal Arteriolar Diameters and Elevated Blood Pressure: The Atherosclerosis Risk in Communities Study
353 Citations1999A. Richey Sharrett, Larry D. Hubbard +6 more
The patterns of association suggested that these signs reflect both transient and persisting structural effects of elevated blood pressure, in agreement with the scant pathologic literature available.
OphthalmologyRetinal microvascular abnormalities and 10-year cardiovascular mortality
343 Citations2003Tien Yin Wong, Ronald Klein +6 more
Retinopathy is independently associated with cardiovascular mortality, and associations for other retinal abnormalities were only observed in middle-aged persons, which support recent studies that suggest retinal microvascular abnormalities provide independent information regarding cardiovascular risk.
American Journal of HypertensionRacial/Ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA)
341 Citations2004Holly Kramer, Chien-Min Han +6 more
Programs to improve hypertension treatment and control should focus on a better understanding of differences in the prevalence of hypertension and hypertension control among minority groups in the United States, especially African Americans, compared with whites, and on techniques to prevent hypertension and improve control in high-risk groups.
DiabetesLeptin induces direct vasodilation through distinct endothelial mechanisms.
332 Citations2000Giuseppe Lembo, Carmine Vecchione +5 more
Leptin-evoked vasorelaxation evoked by leptin is heterogeneous and related to the vascular bed, and the inhibition of nitric oxide synthase by NG-nitro-L-arginine-methyl ester does not modify blood pressure response to leptin, suggesting a predominant role of the EDHF mechanism in the hypotensive effect of leptin.
Annals of Internal MedicineRetinal Arteriolar Diameter and Risk for Hypertension
318 Citations2004Tien Yin Wong, Ronald Klein +7 more
Whether retinal arteriolar narrowing is related to incident hypertension in a cohort of middle-aged normotensive persons is examined and the value of specific antihypertensive treatment targeted at the peripheral microcirculation remains questionable.
Investigative Ophthalmology & Visual ScienceRetinal Vessel Diameters and Their Associations with Age and Blood Pressure
317 Citations2003Tien Yin Wong, Ronald Klein +3 more
The weaker association of retinal arteriolar diameters and BP in older people may reflect greater sclerosis of the retinal arteries preventing a degree of narrowing with higher BP similar to that seen in younger persons.
JAMARetinal Arteriolar Narrowing and Risk of Diabetes Mellitus in Middle-aged Persons
315 Citations2002Tien Yin Wong
Retinal arteriolar narrowing is independently associated with risk of diabetes, supporting a microvascular role in the development of clinical diabetes.
Arteriosclerosis Thrombosis and Vascular BiologyAre Retinal Arteriolar Abnormalities Related to Atherosclerosis?
301 Citations2000Ronald Klein, A. Richey Sharrett +5 more
Results suggest that these arteriolar changes are pathologically distinct from atherosclerosis, and including their measurement in population studies may permit evaluation of the independent contribution of arteriolars disease to various ischemic diseases of the heart, brain, and other organs.
OphthalmologyThe prevalence and risk factors of retinal microvascular abnormalities in older persons
300 Citations2003Tien Yin Wong, Ronald Klein +10 more
It is suggested that retinal microvascular abnormalities reflect processes associated with hypertension but distinct from atherosclerosis, and are common in older persons without diabetes and related to hypertension.
Investigative Ophthalmology & Visual ScienceRelationships between Age, Blood Pressure, and Retinal Vessel Diameters in an Older Population
280 Citations2003Harry Leung, Jie Jin Wang +6 more
Retinal arteriolar and venular diameters narrow with increasing age, and these parameters are inversely related to BP, independent of age, gender, and smoking.
Investigative Ophthalmology & Visual ScienceAssociations between the Metabolic Syndrome and Retinal Microvascular Signs: The Atherosclerosis Risk in Communities Study
276 Citations2004Tien Yin Wong, Bruce Bartholow Duncan +7 more
It is suggested that the metabolic syndrome is associated with microvascular changes in the retina, and associations for arteriovenous nicking, focal arteriolar narrowing, generalized arteriolars narrowing, and venular dilatation were noted, even in people without diabetes or hypertension.
British Journal of OphthalmologyRetinal microvascular abnormalities and blood pressure in older people: the Cardiovascular Health Study
273 Citations2002Tien Yin Wong
The data suggest that retinal microvascular changes reflect severity and duration of hypertension, and generalised retinal arteriolar narrowing and possibly arteriovenous nicking are related to previously elevated blood pressure, independent of concurrent blood pressure.
PubMedAre inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study.
269 Citations2006Ronald Klein, Ronald Klein +3 more
Examination of relationship of systemic markers of inflammation, endothelial dysfunction, and serum folate level to retinal vessel diameter shows an association of inflammatory markers with larger retinal venular diameter, suggesting that retinal Venular caliber may be a marker of systemic inflammation.
OphthalmologyRetinal vessel diameter and open-angle glaucoma
268 Citations2005Paul Mitchell, Harry Leung +5 more
Generalized retinal arteriolar narrowing, an indicator of localized vascular change, is significantly associated with optic nerve damage caused by OAG, and it is not clear whether such a retinalarteriolar change reflects an ischemic process leading to optic nerveDamage or results from loss of retinal neurons secondary to glaucoma.
BMJProspective cohort study of retinal vessel diameters and risk of hypertension
255 Citations2004Tien Yin Wong, Anoop Shankar +3 more
Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.
StrokeRetinal Microvascular Abnormalities and MRI-Defined Subclinical Cerebral Infarction
245 Citations2005Lawton S. Cooper, Tien Yin Wong +7 more
Retinal microvascular abnormalities are associated with MRI-defined subclinical cerebral infarcts independent of stroke risk factors, and data suggest that retinal photography may be useful for studying subclinical cerebrovascular disease in population-based studies.
Archives of OphthalmologyThe Relation of Retinal Vessel Caliber to the Incidence and Progressionof Diabetic Retinopathy
230 Citations2004Ronald Klein
A quantitative measure of retinal vascular caliber provides additional information regarding risk for progression of retinopathy, and larger arteriolar and venular caliber is associated with the 4-year incidence of proliferative Retinopathy.
Archives of Internal MedicineRace and Sex Differentials in the Impact of Hypertension in the United States
211 Citations1989Joan Cornoni‐Huntley
Investigation of changes in blood pressure and frequency of treatment, hypertension incidence, and ten-year survival of the cohort relative to hypertension status at baseline found minimal differences in the incidence of hypertension between men and women for all age groups.
HypertensionHypertensive Retinal Vessel Wall Signs in a General Older Population
197 Citations2003Jie Jin Wang, Paul Mitchell +4 more
A strong relation between presence and severity of hypertension and retinal microvascular structural changes is demonstrated in an older white population.
Journal of HypertensionImpact of current and past blood pressure on retinal arteriolar diameter in an older population
152 Citations2004Harry Leung, Jie Jin Wang +4 more
The data document the independent effects of both current and past blood pressure on small vessel calibre in the retina, suggesting that retinal arteriolar narrowing may result from the cumulative effects of long-standing hypertension.
Archives of Internal MedicineRetinal Arteriolar Narrowing, Hypertension, and Subsequent Risk of Diabetes Mellitus
149 Citations2005Tien Yin Wong
Retinal arteriolar narrowing is related to risk of incident diabetes, and a possible link between systemic arteriole-to-venule ratio narrowing associated with hypertension and diabetes development is suggested.
StrokeImpaired Endothelial Function of the Retinal Vasculature in Hypertensive Patients
143 Citations2004Christian Delles, Georg Michelson +4 more
Endothelial function of the retinal vasculature is impaired in early essential hypertension but can be improved by AT1-receptor blockade.
British Journal of OphthalmologyHypertensive retinopathy and incident coronary heart disease in high risk men
140 Citations2002Bruce Bartholow Duncan
The data support the concept that retinal microvascular changes are markers of blood pressure damage and may be useful in risk stratification and in the tailoring of hypertension treatment decisions.
BMJValue of routine funduscopy in patients with hypertension: systematic review
139 Citations2005Bert‐Jan H. van den Born, Caroline A. Hulsman +3 more
Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients, and the assessment of microvascular changes in the retina is limited by large variation between observers.
DiabetesRetinal Vessel Diameters and the Incidence of Gross Proteinuria and Renal Insufficiency in People With Type 1 Diabetes
132 Citations2004Tien Yin Wong, Anoop Shankar +2 more
In individuals with type 1 diabetes, larger retinal venular diameter is independently associated with the long-term incidence of gross proteinuria and renal insufficiency and may provide additional predictive information regarding risk of nephropathy.
IEEE Transactions on Biomedical EngineeringAutomatic Grading of Retinal Vessel Caliber
128 Citations2005Haizhou Li, Wynne Hsu +2 more
A modified Gaussian model that takes into account the central light reflection of arterioles is proposed to describe the vessel profile and the accuracy of the AVR computation is well within the acceptable range of deviation among the human graders.
American Journal of EpidemiologyGender- and Race-specific Determination of Albumin Excretion Rate using Albumin-to-Creatinine Ratio in Single, Untimed Urine Specimens:The Coronary Artery Risk Development in Young Adults Study
120 Citations2002David R. Jacobs
Men and Blacks have a higher albumin excretion rate than do women and Whites and may thereby have an increased risk of microvascular and macrovascular disease.
JAMABlack-white differences in stroke incidence in a national sample. The contribution of hypertension and diabetes mellitus
118 Citations1990Steven J. Kittner
DiabetesDiameters of the Retinal Vessels in Diabetic and Normal Subjects
86 Citations1969F Skovborg, Aa. V. Nielsen +2 more
It is concluded that vein dilatation is not a particularly early phenomenon in the development of the diabetic retinopathy, but rather an integrated part of the Retinopathy.
DiabetesDiabetic Glycemic Control and Retinal Blood Flow
82 Citations1990Juan E. Grunwald, Alexander J. Brucker +5 more
A lack of decrease in Q at 5 days was associated with the progression ofretinopathy that occurs in some patients after the institution of strict glycemic control and may serve as a predictor for progression of retinopathy.
Journal of HypertensionRetinal microvascular changes and target organ damage in untreated essential hypertensives
79 Citations2004Cesare Cuspidi, Stefano Meani +8 more
A very large fraction of untreated, recently diagnosed hypertensive patients have initial retinal microvascular abnormalities detectable by non-mydriatic retinography, and fundoscopic examination has a limited clinical value to detect widespread organ involvement in early phases of grade 1 and 2 hypertension.
The American Journal of CardiologyBlack-white differences in electrocardiographic left ventricular mass and its association with blood pressure (the ARIC study)
62 Citations1994Donna K. Arnett, Pentti M. Rautaharju +7 more
Black-white differences in the association between antihypertensive therapy, continuous measures of mean arterial and pulse pressures and left ventricular (LV) mass estimated from a multivariable electrocardiographic algorithm were examined and indicate that blacks have higher LV mass than whites, and a more pronounced blood pressure-LV mass relation after controlling for other risk factors and treatment status.
EpidemiologyIn Defense of Standardized Regression Coefficients
61 Citations1991Thomas B. Newman, Warren S. Browner
Examples are provided that demonstrate that, when a risk factor is continuous, standardized regression coefficient may be helpful for comparing variables measured in different units and there is no reason to abandon the use of standardized regression coefficients in epidemiologic analyses.
American Journal of Kidney DiseasesRacial differences in the prevalence of microalbuminuria in hypertension
55 Citations1995John H. Summerson, Ronny A. Bell +1 more
Data are the first to indicate that microalbuminuria may be more prevalent during the course of hypertension in black patients and thus may be an early marker for end-organ damage susceptibility among hypertensive patients.
PubMedBlack-white differences in stroke incidence in a national sample. The contribution of hypertension and diabetes mellitus.
53 Citations1990Steven J. Kittner, Lon R. White +3 more
Journal of HypertensionEthnic differences in skin microvascular function and their relation to cardiac target-organ damage
46 Citations2005W. David Strain, Nish Chaturvedi +5 more
Afro-Caribbeans have poorer microvascular structure and function, unexplained by conventional risk factors, which may contribute to greater rates of vascular target-organ damage.
Arteriosclerosis Thrombosis and Vascular BiologyImpaired Endothelium-Dependent Vascular Responses of Retinal and Intrarenal Arteries in Patients With Type 2 Diabetes
43 Citations1999Takahiko Kawagishi, Miyoko Matsuyoshi +8 more
The results showed that the endothelium-dependent vascular responses of the retinal and intrarenal arteries as well as the brachial artery were impaired in diabetic patients before the clinical manifestation of diabetic nephropathy, and suggest that endothelial dysfunction in these arteries is associated with hyperglycemia in these patients.
Investigative Ophthalmology & Visual ScienceFamilial Aggregation of Retinal Vessel Caliber in the Beaver Dam Eye Study
31 Citations2004Kristine E. Lee, Ronald Klein +2 more
Retinal vessel equivalents were more highly correlated between relatives than between unrelated individuals, and the relative magnitudes of these correlations were likely the result of shared genes.
HypertensionGenetic Determinants of Retinal Vascular Caliber
28 Citations2006Jie Jin Wang, Tien Yin Wong
Advances in retinal photography and computing technologies have made feasible objective measurement of small vessel size from digital retinal images and several large, population-based studies have applied these new techniques to quantitatively measure retinal vessel diameters.