与视网膜静脉阻塞及小动脉栓子有关的心血管危险因素:社区研究及心血管健康研究中的动脉粥样硬化危险性

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Objective: To examine the associations of retinal vein occlusion and arteriola r emboli with cardiovascular disease. Design: Population-based cross-sectional study. Participants: Pooled from the Atherosclerosis Risk in Communities Study (n=12 642; mean age, 60 years) and the Cardiovascular Health Study (n=2824; mean age, 79 years). Methods: Retinal vein occlusion and arteriolar emboli were iden tified from a single nonmydriatic retinal photograph using a standardized protoc ol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including s tandardized carotid ultrasonography. Main Outcome Measures: Retinal vein occlusi on and arteriolar emboli. Results: Prevalences of retinal vein occlusion and art eriolar emboli were 0.3%(n=39 cases) and 0.2%(n=34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odd s ratio [OR], 2.96; 95%confidence interval [CI], 1.43-6.14), systolic bloo d pr essure (BP) (OR, 4.12; 95%CI, 1.40-12.16; highest quartile vs. lowest), diasto lic BP (OR, 2.64; 95%CI, 1.07-6.46; highest quartile vs. lowest), carotid arte ry plaque (OR, 5.62; 95%CI, 2.60-12.16), body mass index (OR, 3.88; 95%CI, 1. 23-12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95%CI, 1. 08-10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95%CI , 2.00-8.36), and focal arteriolar narrowing (OR, 5.17; 95%CI, 2.59-10.29). A fter adjusting for age, retinal arteriolar emboli were associated with hypertens ion (OR, 3.14; 95%CI, 1.44-6.84), systolic BP (OR, 3.46; 95%CI, 1.13-10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33; 95%CI , 1.01-5.42), carotid artery plaque (OR, 4.62; 95%CI, 1.85-11.57), plasma lip oprotein (a) (OR, 3.69; 95%CI, 1.20-11.41; highest quartile vs. lowest), plasm a fibrinogen (OR, 3.09; 95%CI, 0.98-9.76; highest quartile vs. lowest), and cu rrent cigarette smoking (OR, 3.08; 95%CI, 1.47-6.47). Approximately a quarter of participants with retinal vein occlusion and arteriolar emboli had evidence o f carotid artery plaque as defined from ultrasound. Conclusions: Retinal vein oc clusion and retinal arteriolar emboli are associated with carotid artery disease , hypertension, and other cardiovascular risk factors. Objective: To examine the associations of retinal vein occlusion and arteriola r emboli with cardiovascular disease. Design: Population-based cross-sectional study. Participants: Pooled from the Atherosclerosis Risk in Communities Study (n = 12 642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years). Methods: Retinal vein occlusion and arteriolar emboli were iden tified from a single nonmydriatic retinal photograph using a standardized protoc ol. Photographs were also graded for arteriovenous nicking and focal arteriolar All participants had a comprehensive systemic evaluation, including s tandardized carotid ultrasonography. Main Outcome Measures: Retinal vein occlusi on and arteriolar emboli. Results: Prevalences of retinal vein occlusion and art eriolar emboli were 0.3% (n = 39 cases) and 0.2 % (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odd s ratio [OR], 2.96; 95% confidence inter (OR, 4.12; 95% CI, 1.40-12.16; highest quartile vs. lowest), diasto lic BP (OR, 2.64; 95% CI, 1.43-6.14), systolic bloo pr essure 1.07-6.46; highest quartile vs. lowest), carotid arte ry plaque (OR, 5.62; 95% CI, 2.60-12.16), body mass index (OR, 3.88; 95% CI, 1. 23-12.18; highest quartile vs lowest The highest quartile vs. lowest, arteriovenous nicking (OR, 4.09; 95% CI, 2.00-8.36), and focal arteriolar narrowing (OR, 3.29; 95% CI, , 5.17; 95% CI, 2.59-10.29). A fter adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44-6.84), systolic BP , 1.13-10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33; 95% CI 1.01-5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85-11.57), plasma lip oprotein (OR, 3.69; 95% CI, 1.20-11.41; highest quartile vs. lowest), plasm a fibrinogen (OR, 3.09; 95% CI, 0.98-9.76; highest quartile vs. lowest), and cu rrent cigarettApproximately a quarter of participants with retinal vein occlusion and arteriolar emboli had evidence of carotid artery plaque as defined from ultrasound. Conclusions: Retinal vein oc clusion and retinal arteriolar emboli are associated with carotid artery disease, hypertension, and other cardiovascular risk factors.
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