Impact of long-term measures of glucose and blood pressure on the retinal microvasculature

Christy L. Avery, Anna Kucharska-Newton, Keri L. Monda, A. Richey Sharrett, Thomas H. Mosley, Barbara E. Klein, Mary Frances Cotch, Tien Y. Wong, Ronald Klein

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: Retinopathy and retinal microvascular abnormalities are common in adult populations, yet few long-term predictors have been identified. We therefore examined the association between systolic blood pressure (SBP) and fasting plasma glucose, assessed over 18 years, with retinopathy and retinal vascular caliber in 2066 Carotid MRI participants, an Atherosclerosis Risk in Communities ancillary study. Methods: Retinopathy and retinal vascular caliber were assessed by retinal photography. Confounder-adjusted weighted regression models were used to examine exposures defined as cumulative, long-term prospective, concurrent, and 18-year change. Results: Long-term prospective (prevalence odds ratio (POR) per 10 mm Hg: 1.14 (95% CI: 1.01, 1.30)) and cumulative (POR per 10 mm Hg: 1.30 (95% CI: 1.09, 1.56) effects spanning approximately 18 years were found for SBP and retinopathy. The strongest long-term prospective association for plasma glucose and retinopathy was identified at the baseline visit (POR per 10 mg/dl: 1.26 (95% CI: 1.16, 1.38)); sustained glucose elevations over 18 years were also associated with prevalent retinopathy (POR per 10 mg/dl: 1.33 (95% CI: 1.24, 1.43)). Results were robust to the exclusion of participants with diabetes. Conclusions: Modest and sustained long-term elevations in glucose and blood pressure are associated with retinopathy and retinal vascular caliber.

Original languageEnglish
Pages (from-to)412-417
Number of pages6
Issue number2
StatePublished - Dec 2012

Bibliographical note

Funding Information:
CLA was partially supported by grant R00HL098458.

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 , HHSN268201100008C , HHSN268201100009C , HHSN268201100010C , HHSN268201100011C , and HHSN268201100012C ) with the ARIC Carotid MRI examination funded by U01HL075572 and National Institutes of Health Intramural Award ZIAEY000426 from the National Eye Institute . The authors thank the staff and participants of the ARIC study for their important contributions.


  • Blood pressure
  • Epidemiology
  • Glucose
  • Microvascular disease
  • Retinopathy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Impact of long-term measures of glucose and blood pressure on the retinal microvasculature'. Together they form a unique fingerprint.

Cite this