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Tien Yin Wong, MD, PhD

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In reply

My colleagues and I would like to thank de Abreu Silva for raising important issues regarding our article from the Cardiovascular Health Study.¹ We agree that in the study, participants with larger venular caliber were more likely African Americans and had higher levels of cardiovascular risk factors (eg, current smokers and higher glucose and cholesterol levels). Similarly, participants with narrower arteriolar caliber were older and more likely hypertensive. However, in our analysis, we controlled for age, sex, race, systolic and diastolic blood pressure, diabetes, glucose level, cigarette smoking, pack-years of smoking, and high-density lipoprotein and low-density lipoprotein cholesterol levels. Thus, the significant associations of larger retinal venular caliber with incident coronary heart disease and stroke and of narrower arteriolar caliber with incident coronary artery disease were independent of these potential confounders.

We also do not dispute the statement by de Abreu Silva that . . . [Full Text of this Article]

AUTHOR INFORMATION

RELATED LETTERS

Retinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women: The Atherosclerosis Risk in Communities Study
Tien Yin Wong, Ronald Klein, A. Richey Sharrett, Bruce B. Duncan, David J. Couper, James M. Tielsch, Barbara E. K. Klein, and Larry D. Hubbard
JAMA. 2002;287(9):1153-1159.
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Retinal Vasculature Findings Do Not Add Information About Cardiovascular Risk
Erlon Oliveira de Abreu Silva
Arch Intern Med. 2007;167(11):1209-1210.
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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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