Response to Letters Regarding Article, “Mild Retinopathy Is a Risk Factor for Cardiovascular Mortality in Japanese With and Without Hypertension: The Ibaraki Prefectural Health Study”

Abstract

We appreciate the interest of Triantafyllou et al and Cheung et al in our recent article on retinopathy and cardiovascular mortality.1 They pointed out several issues with the article. Triantafyllou et al discussed 3 major points. First, they stated that grade 1 retinopathy did not possess a predictive role for cardiovascular mortality in normotensive individuals. However, the probability value for the trend showed significance in nonhypertensive men and women (Table 3); in addition, the multivariable (including blood pressure levels and antihypertensive medication use) adjusted hazard ratio for grade 1 retinopathy was significantly higher in all (ie, nonhypertensive and hypertensive) men and women (Table 2). These results appear to suggest the predictive role of grade 1 retinopathy. Second, the lack of information on antihypertensive drugs during the follow-up period, especially in nonhypertensive subjects, was pointed out. We excluded subjects who used antihypertensive drugs …