Abstract
Background: The cardiovascular risk associated with different levels of hypertensive retinopathy, including mild, remains unclear. We performed an individual participant meta-analysis from 6 population-based cohort studies to determine the relationship of hypertensive retinopathy with incident cardiovascular outcomes. Methods: We identified cohort studies that objectively assessed hypertensive retinopathy from photographs, documented incident cardiovascular outcomes, and were population-based. Six studies contributed data from 11,013 individuals at baseline with 5–13 years follow-up. Participants were recruited if they had hypertension and did not have confounding conditions such as diabetic retinopathy. Main outcome measures were incident coronary heart disease (CHD), stroke and a composite endpoint of cardiovascular disease (CHD or stroke). Pooled estimates of incident risk ratios (IRR) were obtained after adjusting for age, gender, systolic blood pressure, serum total cholesterol, high density lipoprotein and smoking. Results: Among eligible participants with hypertension and without diabetes, there were 1018/9662 (10.5%) incident CHD events, 708/11,013 (6.4%) incident stroke events and 1317/9378 (14.0%) incident CVD events. Mild hypertensive retinopathy was associated with increased risk of CVD (IRR 1.13, 95% CI 1.00 to 1.27) and CHD (IRR 1.17, 95% CI 1.02 to 1.34) but not stroke; moderate hypertensive retinopathy was associated with increased risk of CVD (IRR 1.25 95% CI 1.02 to 1.53) but not stroke or CHD individually. Conclusions: In persons with hypertension, both mild and moderate hypertensive retinopathy were associated with higher CVD risk.
| Original language | English |
|---|---|
| Article number | 200180 |
| Journal | International Journal of Cardiology: Cardiovascular Risk and Prevention |
| Volume | 17 |
| DOIs | |
| Publication status | Published - Jun 2023 |
Bibliographical note
Funding Information:The Blue Mountains Eye Study was supported by the Australian National Health & Medical Research Council , Canberra, Australia ( NHMRC Grant No: 153,948 , 302068 , 211069 ).
Funding Information:
The Multi-Ethnic Study of Atherosclerosis study is supported contracts N01-HC-95159 through N01-HC-95166 from the National Heart, Lung, and Blood Institute . Additional support was provided by NIH grant HL69979-03 (Klein R and Wong TY).
Funding Information:
The Cardiovascular Health Study is supported by contracts N01-HC-85079 through N01-HC-85086 , N01-HC-35129 , N01 HC-15103 , N01 HC-55222 , N01-HC-75150 , N01-HC-45133 , grant number U01 HL080295 from the National Heart, Lung, and Blood Institute , with additional contribution from the National Institute of Neurological Disorders and Stroke . A full list of principal CHS investigators and institutions can be found at http://www.chs-nhlbi.org/pi .
Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HSN268201100008C , HSN268201100009C , HHSN268201100010C , HSN268201100011C , and HHSN268201100012C ). The authors thank the staff and participants of the ARIC study for their important contributions.
Funding Information:
The Rotterdam study was supported by the Netherlands Organization for Scientific Research ( NWO , 91203014 , 175.010.2005.011 , 91103012 ).
Publisher Copyright:
© 2023
