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The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

Journal of Human Hypertension volume 26, pages 716–722 (2012)Cite this article

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Abstract

Large-artery stiffness is a risk factor for stroke, including cerebral small-vessel disease. Retinal microvascular changes are thought to mirror those in cerebral microvessels. We investigated the relationship between aortic stiffness and retinal microvascular changes in Asian ischemic stroke patients. We studied 145 acute ischemic stroke patients in Singapore who had aortic stiffness measurements using carotid–femoral pulse wave velocity (cPWV). Retinal photographs were assessed for retinal microvessel caliber and qualitative signs of focal arteriolar narrowing, arteriovenous nicking and enhanced arteriolar light reflex. Aortic stiffening was associated with retinal arteriolar changes. Retinal arteriolar caliber decreased with increasing cPWV (r=−0.207, P=0.014). After adjusting for age, gender, hypertension, diabetes, mean arterial pressure and small-vessel stroke subtype, patients within the highest cPWV quartile were more likely to have generalized retinal arteriolar narrowing defined as lowest caliber tertile (odds ratio (OR) 6.84, 95% confidence interval (CI) 1.45–32.30), focal arteriolar narrowing (OR 13.85, CI 1.82–105.67), arteriovenous nicking (OR 5.08, CI 1.12–23.00) and enhanced arteriolar light reflex (OR 3.83, CI 0.89–16.48), compared with those within the lowest quartile. In ischemic stroke patients, aortic stiffening is associated with retinal arteriolar luminal narrowing as well as features of retinal arteriolosclerosis.

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Acknowledgements

This study was supported by grants from the Australian National Health and Medical Research Council (NHMRC grant number 352337) and Singapore National Medical Research Council (NMRC grant number 2004/073, 2003/0801, 2006/1090, 2008/0042).

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Authors and Affiliations

  1. Singapore General Hospital Campus, National Neuroscience Institute, Singapore

    D A De Silva & H-M Chang

  2. National Heart Centre Singapore, Singapore

    F-P Woon & M-C Wong

  3. Singapore General Hospital, Singapore

    J J F Manzano

  4. Singapore Eye Research Institute, Singapore

    E Y Liu & T Y Wong

  5. National University of Singapore, Singapore

    C Chen & T Y Wong

  6. Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia

    J J Wang & T Y Wong

  7. Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia

    J J Wang & P Mitchell

  8. Baker IDI Heart and Diabetes Research Institute, Melbourne, Victoria, Australia

    B A Kingwell

  9. Monash Cardiovascular Research Centre, Melbourne, Victoria, Australia

    J D Cameron

  10. Westmead Clinical School, Sydney, New South Wales, Australia

    R I Lindley

  11. National Medical Research Council, Singapore

    M-C Wong

  12. National Cancer Centre, Singapore

    M-C Wong

Authors
  1. D A De Silva
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  2. F-P Woon
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  3. J J F Manzano
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  4. E Y Liu
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  5. H-M Chang
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  6. C Chen
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  7. J J Wang
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  8. P Mitchell
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  9. B A Kingwell
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  10. J D Cameron
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  11. R I Lindley
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  12. T Y Wong
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  13. M-C Wong
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on behalf of the Multi-Centre Retinal Stroke Study Collaborative Group

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Correspondence to D A De Silva.

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De Silva, D., Woon, FP., Manzano, J. et al. The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients. J Hum Hypertens 26, 716–722 (2012). https://doi.org/10.1038/jhh.2011.88

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  • DOI: https://doi.org/10.1038/jhh.2011.88

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