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Epidemiology |

Relationship of Blood Pressure and Other Factors to Serial Retinal Arteriolar Diameter Measurements Over Time:  The Beaver Dam Eye Study

Ronald Klein, MD, MPH; Chelsea E. Myers, MStat; Michael D. Knudtson, MS; Kristine E. Lee, MS; Ronald Gangnon, PhD; Tien Y. Wong, MD, PhD; Barbara E. K. Klein, MD, MPH
Arch Ophthalmol. 2012;130(8):1019-1027. doi:10.1001/archophthalmol.2012.560.
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Objective  To describe the relationship of blood pressure (BP), antihypertensive medication use, and other factors to serial measurements of retinal arteriolar diameters over time in the Beaver Dam Eye Study.

Methods  Retinal arteriolar diameter was measured by computer-assisted methods and summarized as central retinal arteriolar equivalent (CRAE) in 4573 persons aged 43 to 99 years at 4 examinations (each separated by 5 years) during a 15-year period. Associations of CRAE with risk factors measured concurrently and 5 years previously were determined using multivariate analyses.

Results  While adjusting for image quality, refraction, and lens status, age (per 10 years: β estimate, −0.73; P < .001), systolic BP (per 10 mm Hg: concurrent examination, −2.74; P < .001; previous examination, −1.75; P < .001), smoking status (smoker vs nonsmoker: concurrent examination, 4.29; P < .001; previous examination, 1.63; P = .004), body mass index (per category: concurrent examination, −0.51; P = .05; previous examination, −0.22; P = .44), and heavy alcohol consumption (drinking) (current vs past/never heavy drinker: concurrent examination, −2.54; P = .03; previous examination, −2.42; P = .02) were associated with CRAE. In the same model, there were significant interactions between concurrent and previous systolic BP (0.11; P = .003) and between concurrent and previous body mass index (0.12; P = .04). Use of calcium channel blockers at both the concurrent and past examination (vs neither examination, 1.59; P = .01), but not other classes of antihypertensive drugs, was associated with CRAE.

Conclusions  Retinal arteriolar diameter is independently associated with past and current systolic BP, calcium channel blocker use, smoking status, body mass index, and heavy drinking during 5-year intervals. The relationships with CRAE are stronger for concurrent than for past measures of these variables.

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Figures

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Grahic Jump Location

Figure 1. The relationship between change in systolic blood pressure (SBP) during a 5-year period in people at 3 levels of SBP (normotensive, <140 mm Hg; moderate hypertension, 140-160 mm Hg; and severe hypertension, >160 mm Hg) at the start of the period and the expected central retinal arteriolar equivalent (CRAE) at 5-year follow-up (concurrent) examination. Limit lines indicate standard error.

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Grahic Jump Location

Figure 2. The relationship between change in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) during a 5-year period in people at 3 levels of BMI (normal weight, <25; overweight, 25-30; and obese, >30) at the start of the period and the expected central retinal arteriolar equivalent (CRAE) at 5-year follow-up (concurrent) examinations. There were too few individuals with a normal BMI who lost weight during a 5-year interval to estimate CRAE. Limit lines indicate standard error.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 3. The relationship between change in smoking status during a 5-year period and the expected central retinal arteriolar equivalent (CRAE) at 5-year follow-up (concurrent) examinations. Limit lines indicate standard error.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 4. The relationship between change in heavy drinking status during a 5-year period and the expected central retinal arteriolar equivalent (CRAE) at 5-year follow-up (concurrent) examinations. Limit lines indicate standard error.

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