Association of ideal cardiovascular health metrics and retinal microvascular findings: the Atherosclerosis Risk in Communities Study.
Association of ideal cardiovascular health metrics and retinal microvascular findings: the Atherosclerosis Risk in Communities Study.
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DOI：
10.1161/jaha.113.000430
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发表时间：
2013-11-19
影响因子：
5.4
通讯作者：
Folsom AR
中科院分区：
文献类型：
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作者：
Ogagarue ER;Lutsey PL;Klein R;Klein BE;Folsom AR
本研究评估了动脉粥样硬化风险社区研究中理想心血管（CV）健康的患病率，并确定了其与流行性视网膜病变、视网膜小静脉直径变宽和小动脉直径变窄的关系，这些是亚临床脑血管疾病的风险标志物，与卒中和冠心病（CHD）发病率和死亡率增加相关。我们使用来自社区动脉粥样硬化风险研究的眼底照相测量分级来检查视网膜病变和视网膜小动脉和小静脉口径与理想CV健康指标数量的相关性。视网膜病变患病率与CV健康类别和存在的理想CV健康指标数量呈分级关系：在具有≥5个理想CV健康指标的患者中，视网膜病变患病率为2.1%，而在无理想CV健康指标的患者中，视网膜病变患病率为13.1%（比值比[CI]，4.8 [2.5 - 8.9]）。视网膜中央小静脉等效直径和视网膜中央小动脉等效直径也显示出与CV健康类别和理想CV健康指标数量的分级关系：校正年龄、种族、性别和教育后，平均视网膜中央小静脉当量为187.8 μm（95% CI，186.9至188.6 μm），而在无理想CV健康指标的患者中为201.1 μm（95% CI，199.1至203.1 μm）。在具有≥5个理想CV健康指标的患者中，平均视网膜中央小动脉当量为163.8 μm（95% CI，163.0至164.5 μm），而在具有零个理想CV健康指标的患者中，平均视网膜中央小动脉当量为157.9 μm（95% CI，156.1至159.7 μm）。很少有成年人有理想的心血管健康。那些健康水平最好的人不太可能有视网膜病变的迹象，广泛的视网膜小静脉和狭窄的视网膜小动脉，这与中风和冠心病风险增加有关。
This study evaluated the prevalence of ideal cardiovascular (CV) health in the Atherosclerosis Risk in Communities Study and determined its relationship with prevalent retinopathy, wider retinal venular diameters, and narrower arteriolar diameters, which are risk markers for subclinical cerebrovascular disease and are associated with increased stroke and coronary heart disease (CHD) morbidity and mortality. We used gradings of fundus photography measurements from the Atherosclerosis Risk in Communities Study to examine the association of retinopathy and retinal arteriolar and venular calibers to the number of ideal CV health metrics. Prevalent retinopathy showed a graded relationship with the CV health categories and number of ideal CV health metrics present: retinopathy prevalence was 2.1% among those with ≥5 ideal CV health metrics compared with 13.1% among those with zero ideal CV health metrics (odds ratio [CI]), 4.8 [2.5 to 8.9]). Central retinal venule equivalent and central retinal arteriolar equivalent diameters also showed graded relationships with CV health categories and number of ideal CV health metrics: after adjustment for age, race, sex, and education, mean central retinal venular equivalent was 187.8 μm (95% CI, 186.9 to 188.6 μm) among those with ≥5 ideal CV health metrics compared with 201.1 μm (95% CI, 199.1 to 203.1 μm) among those with zero ideal CV health metrics. Mean central retinal arteriolar equivalent was 163.8 μm (95% CI, 163.0 to 164.5 μm) among those with ≥5 ideal CV health metrics compared with 157.9 μm (95% CI, 156.1 to 159.7 μm) among those with zero ideal CV health metrics. Few adults had ideal cardiovascular health. Those with the best level of health were less likely to have retinopathy signs, wide retinal venules, and narrow retinal arterioles, which are associated with increased stroke and coronary heart disease risk.