Abstract
BackgroundThis study aimed to investigate the correlation between quantitative retinal vascular parameters such as central retinal arteriolar equivalent (CRAE) and retinal vascular fractal dimension (D(f)), and cardiovascular risk factors in the Chinese Han population residing in the in islands of southeast China.Methodology/Principle FindingsIn this cross-sectional study, fundus photographs were collected and semi-automated analysis software was used to analyze retinal vessel diameters and fractal dimensions. Cardiovascular risk factors such as relevant medical history, blood pressure (BP), lipids, and blood glucose data were collected. Subjects had a mean age of 51.9±12.0 years and included 812 (37.4%) males and 1,357 (62.6%) females. Of the subjects, 726 (33.5%) were overweight, 226 (10.4%) were obese, 272 (12.5%) had diabetes, 738 (34.0%) had hypertension, and 1,156 (53.3%) had metabolic syndrome. After controlling for the effects of potential confounders, multivariate analyses found that age (β = 0.06, P = 0.008), sex (β = 1.33, P = 0.015), mean arterial blood pressure (β = −0.12, P<0.001), high-sensitivity C-reactive protein (β = −0.22, P = 0.008), and CRVE (β = 0.23, P<0.001) were significantly associated with CRAE. Age (β = −0.0012, P<0.001), BP classification (prehypertension: β = −0.0075, P = 0.014; hypertension: β = −0.0131, P = 0.002), and hypertension history (β = −0.0007, P = 0.009) were significantly associated with D(f).Conclusions/SignificanceD(f) exhibits a stronger association with BP than CRAE. Thus, D(f) may become a useful indicator of cardiovascular risk.
Highlights
Retinal vessels are the only segment of the human microcirculation that can be observed directly
Quantitative assessment of retinal vascular parameters is a precise and reliable method of investigating the relationship between microcirculation and cardiovascular disease [8], and most studies have focused on retinal vascular caliber, which is correlated with blood pressure (BP) [9]
A recent study conducted over an 18-year period found that every 10 mm Hg increase in mean systolic blood pressure (SBP) was associated with a 1.9 reduction in central retinal arteriolar equivalent (CRAE) [12]
Summary
Retinal vessels are the only segment of the human microcirculation that can be observed directly. The associations between central retinal arteriolar equivalent (CRAE) and many cardiovascular risk factors have been demonstrated [1,2,3,4,5]. The American Heart Association estimates that more than 1 in 3 adults Americans have one or more types of cardiovascular disease [6]. Quantitative assessment of retinal vascular parameters is a precise and reliable method of investigating the relationship between microcirculation and cardiovascular disease [8], and most studies have focused on retinal vascular caliber, which is correlated with blood pressure (BP) [9]. This study aimed to investigate the correlation between quantitative retinal vascular parameters such as central retinal arteriolar equivalent (CRAE) and retinal vascular fractal dimension (D(f)), and cardiovascular risk factors in the Chinese Han population residing in the in islands of southeast China
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