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Multicenter Study
. 2012 Dec;225(2):412-7.
doi: 10.1016/j.atherosclerosis.2012.10.034. Epub 2012 Oct 12.

Impact of Long-Term Measures of Glucose and Blood Pressure on the Retinal Microvasculature

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Free PMC article
Multicenter Study

Impact of Long-Term Measures of Glucose and Blood Pressure on the Retinal Microvasculature

Christy L Avery et al. Atherosclerosis. .
Free PMC article

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.

Figures

Figure 1
Figure 1
Associations of systolic blood pressure (SBP) with retinopathy (panel a), central retinal artery equivalent (panel b), and central retinal venous equivalent (panel c) estimated in n=2,066 Atherosclerosis Risk in Communities (ARIC) Carotid MRI study participants, 1987–2006. Visit-specific cross-sections refer to SBP measured at ARIC Visits 1–4 and the CarMRI visit and are adjusted for earlier SBP measures. Estimates are presented per 10 mmHg SBP.
Figure 2
Figure 2
Associations of fasting glucose with retinopathy (panel a), central retinal artery equivalent (panel b), and central retinal venous equivalent (panel c) estimated in n=2,066 Atherosclerosis Risk in Communities (ARIC) Carotid MRI study participants, 1987–2006. Visit-specific cross-sections refer to fasting glucose measured at ARIC Visits 1–4 and the CarMRI visit and are adjusted for earlier glucose measures. Estimates are presented per 10 mg/dl fasting glucose.

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