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Retinal Arteriolar Diameter and Risk for Hypertension

Tien Yin Wong, MD, PhD; Ronald Klein, MD, MPH; A. Richey Sharrett, MD, DrPH; Bruce B. Duncan, MD, PhD; David J. Couper, PhD; Barbara E.K. Klein, MD, MPH; Larry D. Hubbard, MAT; F. Javier Nieto, MD, PhD, Atherosclerosis Risk in Communities Study
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From University of Melbourne, Victoria, Australia; Singapore Eye Research Institute, National University of Singapore, Singapore; University of Wisconsin, Madison, Wisconsin; Johns Hopkins University, Baltimore, Maryland; Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil; and University of North Carolina, Chapel Hill, North Carolina.


Acknowledgment: The authors thank the staff and participants in the ARIC study for their important contributions.

Grant Support: By National Heart, Lung, and Blood Institute contracts N01-HC-35125, N01-HC-35126, N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. Additional support was provided by National Institutes of Health grant EYO13939 (Drs. Wong and Klein) and a Centers of Excellence Grant of CNPq (the Brazilian National Research Council) (Dr. Duncan).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Tien Yin Wong, MD, PhD, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne 3002, Australia; e-mail, ophwty@nus.edu.sg.

Author Contributions: Conception and design: T.Y. Wong, R. Klein, B.E.K. Klein.

Analysis and interpretation of the data: T.Y. Wong, F.J. Nieto.

Drafting of the article: T.Y. Wong, F.J. Nieto.

Critical revision of the article for important intellectual content: T.Y. Wong, R. Klein, A.R. Sharrett, B.B. Duncan, D.J. Couper, B.E.K. Klein, L.D. Hubbard, F.J. Nieto.

Final approval of the article: T.Y. Wong, R. Klein, A.R. Sharrett, B.B. Duncan, D.J. Couper, B.E.K. Klein, L.D. Hubbard, F.J. Nieto.

Statistical expertise: B.B. Duncan, D.J. Couper.

Obtaining of funding: T.Y. Wong, R. Klein, B.E.K. Klein.

Administrative, technical, or logistic support: R. Klein, B.E.K. Klein, L.D. Hubbard, F.J. Nieto.

Collection and assembly of data: R. Klein, B.B. Duncan, D.J. Couper, B.E.K. Klein, L.D. Hubbard.

Current Author Addresses: Dr. Wong: Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne 3001, Australia.

Drs. R. Klein, B.E.K. Klein, and Hubbard: Department of Ophthalmology, University of Wisconsin, 610 North Walnut Street, Madison, WI 53726.

Dr. Sharrett: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205.

Dr. Duncan: Social Medicine Department, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600/414, Porto Alegre, RS 90035-003, Brazil.

Dr. Couper: Department of Biostatistics, University of North Carolina, 137 East Franklin Street, Chapel Hill, NC 27599.

Dr. Nieto: Department of Population Health Sciences, University of Wisconsin, 61l North Walnut Street, Madison, WI 53705.


Ann Intern Med. 2004;140(4):248-255. doi:10.7326/0003-4819-140-4-200402170-00006
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The mean arteriole-to-venule ratio (±SD) in the sample was 0.858 ± 0.008. Table 1 shows participant characteristics according to arteriole-to-venule ratio quintiles. In general, persons with lower ratios were more likely to be male and African American; to have higher systolic and diastolic blood pressures, body mass index, waist-to-hip ratio, and triglyceride levels; and to have a lower sports activity index. The arteriole-to-venule ratio was not related to age, diabetes, or fasting glucose levels.

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Figures

Grahic Jump Location
Figure 1.
Study design and population.

ARIC = Atherosclerosis Risk in Communities; MD = Maryland; MN = Minnesota.

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Figure 2.
Retinal photographs with arteriole-to-venule ratios.

Top. Retinal photograph showing an arteriole-to-venule ratio of 0.63. The white arrows denote arterioles, and the black arrows denote venules. Bottom. Retinal photograph showing an arteriole-to-venule ratio of 1.05. The white arrows denote arterioles, and the black arrows denote venules.

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Grahic Jump Location
Figure 3.
Mean systolic and diastolic blood pressures over Atherosclerosis Risk in Communities (ARIC) Study examinations 1 to 4 in relationship to retinal arteriolar diameters.

For patients who were taking antihypertensive medication at examination 4, a systolic blood pressure of 148 mm Hg was imputed if the measured blood pressure was lower than 148 mm Hg, and a diastolic blood pressure of 78 mm Hg was imputed if measured blood pressure was lower than 78 mm Hg.

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Summary for Patients

Do Narrowed Blood Vessels Lead to Hypertension?

The summary below is from the full report titled “Retinal Arteriolar Diameter and Risk for Hypertension.” It is in the 17 February 2004 issue of Annals of Internal Medicine (volume 140, pages 248-255). The authors are T.Y. Wong, R. Klein, A.R. Sharrett, B.B. Duncan, D.J. Couper, B.E.K. Klein, L.D. Hubbard, and F.J. Nieto, for the Atherosclerosis in Communities Study.

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