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Impact of long-term measures of glucose and blood pressure on the retinal microvasculature.

TitleImpact of long-term measures of glucose and blood pressure on the retinal microvasculature.
Publication TypeJournal Article
Year of Publication2012
AuthorsAvery CL, Kucharska-Newton AMaria, Monda KL, Sharrett ARichey, Mosley TH, Klein BE, Cotch M F, Wong TY
Secondary AuthorsKlein R
JournalAtherosclerosis
Volume225
Issue2
Pagination412-7
Date Published2012 Dec
ISSN1879-1484
KeywordsAged, Biomarkers, Blood Glucose, Blood Pressure, Diabetic Retinopathy, Female, Glucose Metabolism Disorders, Humans, Hypertension, Hypertensive Retinopathy, Linear Models, Logistic Models, Longitudinal Studies, Male, Microvessels, Middle Aged, Odds Ratio, Prevalence, Prospective Studies, Retinal Vessels, Risk Factors, Systole, Time Factors, United States
Abstract

OBJECTIVE: Retinopathy and retinal microvascular abnormalities are common in adult populations, yet few long-term predictors have been identified. We therefore examined the association between systolic blood pressure (SBP) and fasting plasma glucose, assessed over 18 years, with retinopathy and retinal vascular caliber in 2066 Carotid MRI participants, an Atherosclerosis Risk in Communities ancillary study.

METHODS: Retinopathy and retinal vascular caliber were assessed by retinal photography. Confounder-adjusted weighted regression models were used to examine exposures defined as cumulative, long-term prospective, concurrent, and 18-year change.

RESULTS: Long-term prospective (prevalence odds ratio (POR) per 10 mm Hg: 1.14 (95% CI: 1.01, 1.30)) and cumulative (POR per 10 mm Hg: 1.30 (95% CI: 1.09, 1.56) effects spanning approximately 18 years were found for SBP and retinopathy. The strongest long-term prospective association for plasma glucose and retinopathy was identified at the baseline visit (POR per 10 mg/dl: 1.26 (95% CI: 1.16, 1.38)); sustained glucose elevations over 18 years were also associated with prevalent retinopathy (POR per 10 mg/dl: 1.33 (95% CI: 1.24, 1.43)). Results were robust to the exclusion of participants with diabetes.

CONCLUSIONS: Modest and sustained long-term elevations in glucose and blood pressure are associated with retinopathy and retinal vascular caliber.

DOI10.1016/j.atherosclerosis.2012.10.034
Alternate JournalAtherosclerosis
PubMed ID23102597
PubMed Central IDPMC3513355
Grant ListR00 HL098458 / HL / NHLBI NIH HHS / United States
Z01 EY000426-05 / / Intramural NIH HHS / United States
U01HL075572 / HL / NHLBI NIH HHS / United States
Z99 EY999999 / / Intramural NIH HHS / United States
ZIA EY000426-10 / / Intramural NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
ZIA EY000426-13 / / Intramural NIH HHS / United States
R00HL098458 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
ZIA EY000426-08 / / Intramural NIH HHS / United States
Z01 EY000426-04 / / Intramural NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
ZIA EY000426-11 / / Intramural NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100007C / / PHS HHS / United States
ZIA EY000426-09 / / Intramural NIH HHS / United States
ZIA EY000426-07 / / Intramural NIH HHS / United States
ZIA EY000426-12 / / Intramural NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
ZIA EY000426-06 / / Intramural NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States
ZIAEY000426 / / PHS HHS / United States