Secondary Logo

Institutional members access full text with Ovid®

Association of retinal vessel calibers and longitudinal changes in arterial stiffness: the Nagahama study

Kawashima-Kumagai, Kyokoa; Tabara, Yasuharub; Yamashiro, Kenjia; Setoh, Kazuyab; Yoshikawa, Munemitsua; Kawaguchi, Takahisab; Miyake, Masahiroa; Nakanishi, Hideoa; Muraoka, Yukia; Takahashi, Yoshimitsuc; Kosugi, Shinjid; Nakayama, Takeoc; Yoshimura, Nagahisaa; Matsuda, Fumihikob; Tsujikawa, Akitakaaon behalf of the Nagahama Study group

doi: 10.1097/HJH.0000000000001602

Objective: Morphological change in retinal vessel calibers has been reported as a marker of cardiovascular risk, but its association with arterial stiffening, a possible factor relating retinal vessel sings and cardiovascular outcomes, is not clear. The study aim was to clarify the relationship between retinal small vessel calibers and longitudinal change in large arterial stiffness in a sample of the general population.

Methods: The study included 6720 Japanese participants (52.1 ± 12.8 years). Central retinal arteriolar equivalent (CRAE) and venular equivalent were measured by fundus photography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV) at baseline and at 5 years.

Results: The overall change in baPWV (ΔbaPWV) during a mean follow-up 1814 ± 136 days was 41 ± 131 cm/s (3.4 ± 9.9%), and was significantly increased in individuals with narrower CRAE (quartiles: Q1, 4.3 ± 10.6%; Q2, 3.3 ± 10.0%; Q3, 3.1 ± 9.3%; Q4, 3.1 ± 9.7%, P = 0.001). No significant association was observed with central retinal venular equivalent. Multivariate analysis identified CRAE as a significant inverse determinant of ΔbaPWV (β = −0.033, P = 0.006) independent of possible covariates including age, sex, blood pressure, and baseline baPWV. The association between CRAE and ΔbaPWV was prominent in a middle-aged (age Q2, β = −0.078, P = 0.002), but not younger (Q1, P = 0.232) or older (Q3, P = 0.427; Q4, P = 0.542) participants.

Conclusion: Narrower CRAE in middle-age was associated with the long-term risk of arteriosclerosis in a general population sample.

aDepartment of Ophthalmology and Visual Sciences

bCenter for Genomic Medicine, Kyoto University Graduate School of Medicine

cDepartment of Health Informatics

dDepartment of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan

Correspondence to Yasuharu Tabara, PhD, Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawara-cho, Sakyo-ku, Kyoto 606-8507, Japan. Tel: +81 75 751 4157; fax: +81 75 751 4167; e-mail:

Abbreviations: baPWV, brachial-to-ankle pulse wave velocity; BP, blood pressure; CHD, coronary heart disease; CRAE, central retinal arteriolar equivalent; CRVE, central retinal venular equivalent; HOMA-IR, homeostasis model assessment index for insulin resistance; RVC, retinal vessel caliber

Received 22 June, 2017

Revised 7 August, 2017

Accepted 26 September, 2017

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.