RETINAL ARTERIOLAR ABNORMALITIES AND CV MORTALITY

描述：该应用程序描述了一项基于人群的病例队列研究 确定视网膜小动脉改变(全身性狭窄、局灶性 狭窄和动静脉划痕)和视网膜病变与 与中风和缺血性心脏病相关的10年死亡率。这项研究 人群将从海狸大坝眼科研究的参与者中挑选出来， 年龄43-86岁的以白人为主的特征鲜明的人群 在1988-90年的基线检查中。案例被定义为参与者 自基线以来已死于中风或缺血性心脏病 考试。每个病例将从队列中选出三名参与者，时间为 基线作为对照，按性别和5岁年龄间隔与病例相匹配。 局灶性小动脉狭窄、动静脉划痕和视网膜病变 使用标准化的摄影评分方案将其评分至基线。至 评估泛发性小动脉狭窄，一种改进的方法 将使用社区中的动脉粥样硬化风险研究。视网膜照片 将被数字化并使用高分辨率扫描仪进行处理。视网膜 然后在计算机的帮助下测量小动脉和小静脉的宽度 基于血管和背景像素密度对比度的程序 视网膜。最后，小动脉的平均宽度将被总结为 视网膜小动脉/小静脉比率(AVR)。标准病例对照方法将 用于计算广义关联的相对赔率 视网膜小动脉狭窄(使用不同类别的AVR)和其他 中风和缺血性心脏病相关死亡率的变化。物流 控制潜在混杂因素(例如，血压， 血脂水平)将被用来评估独立的相关性 视网膜小动脉特征与卒中和缺血性心脏的关系 疾病死亡率。这项研究的数据将提高对 微血管特征与心血管死亡率之间的关系。

DESCRIPTION: The application describes a population-based case-cohort study to determine whether retinal arteriolar changes (generalized narrowing, focal narrowing and arterio-venous nicking) and retinopathy are associated with 10-year stroke-and ischemic heart disease-related mortality. The study population will be selected from participants of the Beaver Dam Eye Study, a well-characterized population of predominantly white persons aged 43-86 years at the baseline examination in 1988-90. Cases are defined as participants who have died from either stroke or ischemic heart disease since the baseline examination. Three participants per case will be selected from the cohort at baseline as controls, matched on gender and 5-year age intervals to cases. Focal arteriolar narrowing, arteriovenous nicking and retinopathy have been graded to baseline using a standardized photographic grading protocol. To evaluate generalized arteriolar narrowing, a method modified from the Atherosclerosis Risk in Communities Study will be used. Retinal photographs will be digitized and processed using a high-resolution scanner. Retinal arteriole and venule widths will then be measured with the help of a computer program based on pixel density contrast between the vessel and the background retina. Finally, the average width of the arterioles will be summarized as a retinal arteriole to venule ratio (AVR). Standard case-control methodology will be applied to calculate the relative odds of association between generalized retinal arteriolar narrowing (using different categories of AVR) and other changes with stroke-and ischemic heart disease-related mortality. Logistic regression models controlling for potential confounders (e.g., blood pressure, serum lipid levels) will be employed to evaluate the independent association between retinal arteriolar characteristics and stroke- and ischemic heart disease mortality. Data from this study will improve the understanding of the association between microvascular characteristics and cardiovascular mortality.