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Retinal Vascular Caliber, Blood Pressure, and Cardiovascular Risk Factors in an Asian Population: The Singapore Malay Eye Study

¹From the Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; the ²Centre for Vision Research, University of Sydney, Sydney, Australia; the ³Department of Community, Occupational, and Family Medicine and the ⁴Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; the ⁵Singapore National Eye Center, Singapore; and the ⁶Department of Endocrinology, Singapore General Hospital, Singapore.

PURPOSE. To describe the relationship of retinal vascular caliber with cardiovascular risk factors in an Asian population.

METHODS. The Singapore Malay Eye Study is a population-based, cross-sectional survey that included 3280 (78.7% response) persons aged 40 to 80 years. Retinal vascular caliber was measured from digital retinal photographs using a validated standardized protocol. Data on major cardiovascular risk factors were collected from all participants.

RESULTS. Of the 3019 participants with retinal vascular caliber data available, the mean retinal arteriolar caliber (CRAE) was 139.5 ± 15.7 µm (SD), and mean venular caliber (CRVE) was 219.3 ± 22.2 µm (SD). Smaller retinal arteriolar caliber was associated with higher current mean blood pressure and male sex (P < 0.001 for both). Larger retinal venular caliber was associated with younger age, current cigarette smoking, greater body mass index, higher glycosylated hemoglobin level, and lower HDL cholesterol (P = 0.012 for glycosylated hemoglobin level and P < 0.001 for other risk factors). The association of retinal arteriolar narrowing and blood pressure was stronger in younger people than in older people and in men than in women (P for interaction < 0.001 for both).

CONCLUSIONS. In this Asian population, smaller retinal arteriolar caliber was associated with hypertension and larger retinal venular caliber with cigarette smoking, dyslipidemia, hyperglycemia, and higher body mass index. The pattern of these associations is similar to that in white populations.