Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
J Am Heart Assoc. 2013 Nov 19;2(6):e000430. doi: 10.1161/JAHA.113.000430.
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.
本研究评估了社区动脉粥样硬化风险研究中理想心血管健康的流行情况，并确定了其与普遍存在的视网膜病变、更宽的视网膜静脉直径和更窄的视网膜小动脉直径之间的关系，这些都是亚临床脑血管疾病的风险标志物，与增加的中风和冠心病（CHD）发病率和死亡率相关。
我们使用社区动脉粥样硬化风险研究中的眼底摄影测量分级，研究了视网膜病变以及视网膜小动脉和小静脉的口径与理想心血管健康指标数量之间的关系。普遍存在的视网膜病变与心血管健康类别和存在的理想心血管健康指标数量呈分级关系：与存在零个理想心血管健康指标的患者相比，存在≥5 个理想心血管健康指标的患者中视网膜病变的患病率为 2.1%（比值比[CI]），4.8[2.5 至 8.9]）。中央视网膜静脉等效直径和中央视网膜小动脉等效直径也与心血管健康类别和理想心血管健康指标数量呈分级关系：在调整年龄、种族、性别和教育程度后，存在≥5 个理想心血管健康指标的患者的中央视网膜静脉等效直径平均值为 187.8μm（95%CI，186.9 至 188.6μm），而存在零个理想心血管健康指标的患者为 201.1μm（95%CI，199.1 至 203.1μm）。存在≥5 个理想心血管健康指标的患者的中央视网膜小动脉等效直径平均值为 163.8μm（95%CI，163.0 至 164.5μm），而存在零个理想心血管健康指标的患者为 157.9μm（95%CI，156.1 至 159.7μm）。
很少有成年人拥有理想的心血管健康。健康状况最佳的人群发生视网膜病变、视网膜静脉变宽和视网膜小动脉变窄的可能性较低，而这些变化与中风和冠心病风险增加相关。
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