This proposal describes a study to determine the relation of retinal microvascular signs to incident cardiovascular disease (stroke and coronary heart disease [CHD]), prevalent cognitive impairment, prevent depression and apoliprotein E (APOE) gene in older persons participating in the Cardiovascular Health Study (CHS). It builds upon new data that in middle-aged people, retinal microvascular signs, as documented from retinal photographs, are associated with a range of cardiovascular disorders, including stroke, CHD (in women) and cognitive dysfunction, independent of blood pressure and other risk factors. The CHS is a population-based study of four communities among older people where both retinal microvascular changes and systemic vascular diseases are measured in detail according to standard protocols. Participants were first examined at baseline in 1989-90, and followed up yearly. In 1997-98, retinal photography was added to the study examination, when participants had a median age of 77 years (range 69 to 97 years). These photographs have already been graded for presence of retinal microvascular signs (retinopathy, generalized and focal arteriolar narrowing, and arterio-venous nicking) according to a standardized protocol. At each examination, detailed information was collected on cardiovascular disease, cognitive function and depression. APOE genotyping is available on all participants. In the current study, we will examine the relation of retinal vascular signs to incidence of stroke/CHD, prevalence of cognitive impairment and depression, and to the APOE gene. Results of the proposed series of analyses will provide new information regarding the impact of microvascular disease to the development of common vascular conditions of the heart and brain as people age. This may ultimately lead to improved identification, and preventive and therapeutic strategies for the most common causes of morbidity, disability and mortality affecting elderly people in the United States.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HL077166-02
Application #
6935264
Study Section
Biology and Diseases of the Posterior Eye Study Section (BDPE)
Program Officer
Desvigne-Nickens, Patrice
Project Start
2004-09-01
Project End
2006-08-31
Budget Start
2005-09-01
Budget End
2006-08-31
Support Year
2
Fiscal Year
2005
Total Cost
$27,000
Indirect Cost
Name
University of Melbourne
Department
Type
DUNS #
753575117
City
Melbourne
State
Country
Australia
Zip Code
3010
Kim, Dae Hyun; Grodstein, Francine; Newman, Anne B et al. (2015) Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study. J Am Geriatr Soc 63:1886-93
Kim, Dae Hyun; Grodstein, Francine; Newman, Anne B et al. (2014) Prognostic implications of microvascular and macrovascular abnormalities in older adults: cardiovascular health study. J Gerontol A Biol Sci Med Sci 69:1495-502
Kawasaki, Ryo; Xie, Jing; Cheung, Ning et al. (2012) Retinal microvascular signs and risk of stroke: the Multi-Ethnic Study of Atherosclerosis (MESA). Stroke 43:3245-51
Kim, Dae Hyun; Chaves, Paulo H M; Newman, Anne B et al. (2012) Retinal microvascular signs and disability in the Cardiovascular Health Study. Arch Ophthalmol 130:350-6
Kim, Dae Hyun; Newman, Anne B; Hajjar, Ihab et al. (2011) Retinal microvascular signs and functional loss in older persons: the cardiovascular health study. Stroke 42:1589-95
Moorthy, Sonia; Cheung, Ning; Klein, Ronald et al. (2011) Are lung disease and function related to age-related macular degeneration? Am J Ophthalmol 151:375-9
Kawasaki, Ryo; Cheung, Ning; Islam, F M Amirul et al. (2011) Is diabetic retinopathy related to subclinical cardiovascular disease? Ophthalmology 118:860-5
Liew, Gerald; Campbell, Stephen; Klein, Ronald et al. (2011) Ten-year longitudinal changes in retinal microvascular lesions: the atherosclerosis risk in communities study. Ophthalmology 118:1612-8
Tikellis, Gabriella; Anuradha, Satyamurthy; Klein, Ronald et al. (2010) Association between physical activity and retinal microvascular signs: the Atherosclerosis Risk in Communities (ARIC) Study. Microcirculation 17:381-93
Sun, Cong; Klein, Ronald; Wong, Tien Y (2009) Age-related macular degeneration and risk of coronary heart disease and stroke: the Cardiovascular Health Study. Ophthalmology 116:1913-9

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