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Erlon Oliveira de Abreu Silva, MD

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The Cardiovascular Health Study by Wong et al¹ affirms that larger retinal caliber is independently associated with the risk of cardiovascular disease in elderly persons. About this, some considerations must be made.

First, the participants in the fourth quartile of venular caliber (eg, the largest one) had a higher proportion of African Americans and current smokers; higher fasting plasma glucose, total plasma cholesterol, and C-reactive protein levels; and higher body mass indexes. All of these values were significantly different from those in the first quartile sample. Second, in the smallest arteriolar caliber sample, a greater proportion of subjects were hypertensive and older than those in the largest arteriolar caliber group. These differences also were significant. Third, the authors discuss the importance of evaluating microcirculation as a tool for cardiovascular risk prediction and the potential beneficial effects of drugs acting on this vascular bed.

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RELATED LETTERS

Quantitative Retinal Venular Caliber and Risk of Cardiovascular Disease in Older Persons: The Cardiovascular Health Study
Tien Yin Wong, Aruna Kamineni, Ronald Klein, A. Richey Sharrett, Barbara E. Klein, David S. Siscovick, Mary Cushman, and Bruce B. Duncan
Arch Intern Med. 2006;166(21):2388-2394.
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Retinal Vasculature Findings Do Not Add Information About Cardiovascular Risk—Reply
Tien Yin Wong
Arch Intern Med. 2007;167(11):1210.
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