Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
J Hypertens. 2020 Feb;38(2):266-273. doi: 10.1097/HJH.0000000000002252.
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.
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.
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).
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.
视网膜微血管为脑血管提供了一个窗口,使我们能够检查视网膜口径的变化,这些变化可能与脑血管疾病中发生的变化相似。在人群样本中,中央动脉僵硬与视网膜血管口径之间的关联尚未完全阐明。
在 1706 名年龄在 76.3 岁(女性占 58.1%)的社区动脉粥样硬化风险研究中的老年人中,我们检查了中央动脉僵硬[颈动脉-股动脉脉搏波速度(cfPWV)]与视网膜血管口径[视网膜中央小动脉等效值(CRAE)和视网膜中央静脉等效值(CRVE)]之间的横断面关联。我们在调整年龄、性别、种族-现场中心、BMI、吸烟和 2 型糖尿病后,估计 cfPWV 与 CRAE 变窄(<第 25 百分位数)和 CRVE 变宽(>第 75 百分位数)之间的关联。我们测试了性别、高血压和 2 型糖尿病的效应修饰作用。
颈动脉-股动脉 PWV(m/s)与 CRAE 变窄的几率无关[比值比(OR):0.99;95%置信区间:0.95-1.03]。cfPWV 与 CRVE 变宽的关联在无高血压的人群中更强(OR:1.10;95%置信区间:1.01-1.20),在有高血压的人群中稍弱(OR:1.01;95%置信区间:0.96-1.05),在有 2 型糖尿病的人群中稍强(OR:1.07;95%置信区间:1.00-1.14),在无 2 型糖尿病的人群中稍弱(OR:1.01;95%置信区间:0.96-1.06)。
在老年人中,cfPWV 与更宽的视网膜静脉口径相关,尤其是在无高血压的人群中。中央动脉僵硬可能与大脑微血管变化有关,如视网膜血管成分所表现的那样。