To determine if vital exhaustion
, a measure of negative emotion, is associated with microvascular changes in the retina. Negative psychological factors, such as depression
, have been implicated in the development of cardiovascular disease
. Whether this link is mediated by macrovascular or microvascular disease
We performed a population-based, cross-sectional study of 10,364 White and African Americans aged 48 to 73 years. Vital exhaustion
scores were determined from the Maastricht questionnaire and categorized into quartiles. Retinopathy
signs and retinal vascular caliber
were graded from retinal photographs following standardized protocols.
After adjusting for age, gender, race, study center, education, smoking, blood pressure, diabetes, and other risk factors, higher vital exhaustion
scores (highest versus lowest quartiles) were associated modestly with the presence of retinopathy
(odds ratio [OR] = 1.27; 95% Confidence Interval [CI] = 1.01–1.59), particularly retinal hemorrhages (OR = 1.71; 95% CI = 1.20–2.44), and with generalized retinal venular widening (OR = 1.19; 95% CI = 1.03–1.38). Analyzing vital exhaustion
as a continuous variable did not change the pattern of the associations.
Middle-aged people with vital exhaustion
may be more likely to have retinopathy
signs that have been identified as risk predictors of cardiovascular events. Further research is needed to explore the possible adverse effects of negative emotion on the microcirculation.