02264nas a2200265 4500000000100000008004100001260001700042100002000059700001600079700001600095700001200111700001500123700001100138700001300149700001200162700001200174700001600186700001500202700001200217700001200229245011900241250001500360520157700375020004601952 2011 d c2293204690591 aLindley Richard1 aMitchell P.1 aDe Silva D.1 aWoon F.1 aManzano J.1 aLiu E.1 aChang H.1 aChen C.1 aWang J.1 aKingwell B.1 aCameron J.1 aWong T.1 aWong M.00aThe relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients a2011/10/073 a

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.Journal of Human Hypertension advance online publication, 6 October 2011; doi:10.1038/jhh.2011.88.

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