Mild Hypertensive Retinopathy and Risk of Cardiovascular Disease: The Suita Study
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- Li Jiaqi
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Public health, Department of Social Medicine, Osaka University Graduate School of Medicine
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- Kokubo Yoshihiro
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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- Arafa Ahmed
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Public health, Department of Social Medicine, Osaka University Graduate School of Medicine Department of Public Health, Faculty of Medicine, Beni-Suef University
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- Sheerah Haytham A.
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Public health, Department of Social Medicine, Osaka University Graduate School of Medicine Health Promotion and Health Education Research Chair, King Saud University
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- Watanabe Makoto
- Division of Preventive Healthcare, National Cerebral and Cardiovascular Center
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- Nakao Yoko M.
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center present affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds
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- Honda-Kohmo Kyoko
- Division of Preventive Healthcare, National Cerebral and Cardiovascular Center
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- Kashima Rena
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Public Health Division, Ibaraki Public Health Center, Osaka Prefectural Government
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- Sakai Yukie
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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- Watanabe Emi
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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- Teramoto Masayuki
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Public health, Department of Social Medicine, Osaka University Graduate School of Medicine
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- Dohi Tomoharu
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Koga Masatoshi
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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Abstract
<p> Aims: This study aimed to investigate the association of mild hypertensive retinopathy with cardiovascular disease (CVD) risk.</p><p> Methods: A total of 7,027 residents aged 30–79 years without a history of CVD participated in the annual health checkups and retinal photography assessments. Retinal microvascular abnormalities were graded using the standard protocols and classified according to the Keith–Wagener–Barker classification. Mild hypertensive retinopathy was defined as grades 1 and 2. Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for total CVD and its subtypes according to the presence and absence of mild hypertensive retinopathy.</p><p>Results: During a median follow-up of 17 years, 351 incident stroke and 247 coronary heart disease (CHD) cases were diagnosed. After adjustment for traditional cardiovascular risk factors, mild hypertensive retinopathy was positively associated with risk of CVD (multivariable HR=1.24; 95% CI, 1.04–1.49) and stroke (1.28; 1.01–1.62) but not with risk of CHD (1.19; 0.89–1.58). Generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk, the multivariable HR (95% CI) was 1.24 (1.00–1.54) and 1.33 (1.02–1.74), respectively. Moreover, mild hypertensive retinopathy was positively associated with stroke risk in normotensive participants.</p><p>Conclusion: Mild hypertensive retinopathy was positively associated with CVD and stroke risk in the urban Japanese population. Especially, generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk. These findings suggested that retinal photography could be helpful for cardiovascular risk stratification in the primary cardiovascular prevention.</p>
Journal
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- Journal of Atherosclerosis and Thrombosis
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Journal of Atherosclerosis and Thrombosis 29 (11), 1663-1671, 2022-11-01
Japan Atherosclerosis Society