Is diabetic retinopathy an independent risk factor for ischemic stroke?

Background And Purpose: The relationship between diabetic retinopathy and ischemic stroke is uncertain and examined in this study.

Methods: A population-based, prospective cohort study of 1617 middle-aged persons with diabetes. Diabetic retinopathy signs were ascertained from retinal photographs, and incident ischemic stroke events were prospectively identified and validated.

Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the cardiovascular health study.

Background: Small vessel disease may contribute to the risk of cardiovascular disease in older persons. We describe the relation of retinal vascular caliber to incident coronary heart disease (CHD) and stroke in elderly persons.

Methods: Prospective population-based cohort study composed of 1992 men and women aged 69 to 97 years living in 4 US communities.

Associations between findings on cranial magnetic resonance imaging and retinal photography in the elderly: the Cardiovascular Health Study.

Associations between findings on cranial magnetic resonance imaging (MRI) and retinal photographs have been described mostly in middle-aged people. In the Cardiovascular Health Study, 1,717 elderly participants underwent MRI and retinal photography between 1991 and 1999. Associations were sought between MRI findings and four findings of retinal microvascular disease: retinopathy, focal arteriolar narrowing, arteriovenous nicking, and the arteriovenous ratio--the last based upon semiautomated measurements of arterioles and venules.

The effect of novel cardiovascular risk factors on the ethnic-specific odds for peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis (MESA).

Objectives: The purpose of this study was to: 1) determine the significance and magnitude of associations between novel cardiovascular disease (CVD) risk factors and peripheral arterial disease (PAD) after adjustment for traditional risk factors; and 2) ascertain the extent to which novel risk factors explain the excess or lower risk for PAD in different ethnic groups.

Background: Previous reports have found a significant difference in the risk of PAD by ethnic group, with some of the risk difference attributed to different levels of traditional CVD risk factors.

Methods: A total of 6,814 individuals free of clinically apparent CVD were enrolled in the MESA (Multiethnic Study of Atherosclerosis) and underwent standardized testing for the presence of PAD by the ankle-brachial index.

Does the impact of smoking on coronary heart disease differ by low-density lipoprotein cholesterol level?: the Atherosclerosis Risk in Communities (ARIC) Study.

Background: The association of smoking with coronary heart disease (CHD) occurrence has been reported to be weaker for populations with lower plasma cholesterol levels. Recent studies suggest that low-density lipoprotein cholesterol (LDL-C) and smoking contribute to different stages of atherosclerosis, so the present study was designed to test the hypothesis that smoking is a stronger risk factor for CHD when LDL-C is high.

Methods And Results: The study group of 13,410 middle-aged adults who were initially free of stroke and CHD were followed and over 13.

Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk In Communities (ARIC) Study.

Background: An association between orthostatic hypotension (OH) and mortality has been reported, but studies are limited to older adults or high-risk populations.

Methods And Results: We investigated the association between OH (a decrease of 20 mm Hg in systolic blood pressure or a decrease of 10 mm Hg in diastolic blood pressure on standing) and 13-year mortality among middle-aged black and white men and women from the Atherosclerosis Risk in Communities Study (1987-1989). At baseline, 674 participants (5%) had OH.

Age-related macular degeneration and risk for stroke.

Background: Age-related macular degeneration (AMD) affects 7 million persons 40 years of age and older in the United States. Risk factors for the disease are similar to those for stroke.

Objective: To determine what relationship, if any, exists between AMD and incident clinical stroke.

An assessment of incremental coronary risk prediction using C-reactive protein and other novel risk markers: the atherosclerosis risk in communities study.

Background: There has been interest in recent years in whether additional, and in particular novel, risk factors or blood markers, such as C-reactive protein, can enhance existing coronary heart disease (CHD) prediction models.

Methods: Using a series of case-cohort studies, the prospective Atherosclerosis Risk in Communities (ARIC) Study assessed the association of 19 novel risk markers with incident CHD in 15,792 adults followed up since 1987-1989. Novel markers included measures of inflammation, endothelial function, fibrin formation, fibrinolysis, B vitamins, and antibodies to infectious agents.

Retinal vascular caliber in persons with type 2 diabetes: the Wisconsin Epidemiological Study of Diabetic Retinopathy: XX.

Purpose: To describe retinal vascular caliber and correlates in people with type 2 diabetes.

Design: Population-based study.

Participants: Thirteen hundred seventy persons diagnosed to have diabetes at or after 30 years of age in an 11-county area in south central Wisconsin from 1980 to 1982.

LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA).

Background: Previous studies showing that smaller low-density lipoprotein (LDL) size is associated with greater atherosclerotic risk did not adequately control for small and large LDL particle correlation.

Methods And Results: We studied the association of lipoproteins measured by proton nuclear magnetic resonance spectroscopy with carotid intima-media thickness (IMT) in apparently healthy individuals (N = 5538, 38% White, 28% African American, 22% Hispanic, 12% Chinese). Small and large LDL particle concentrations (LDL-p) were inversely correlated (r = /-0.

Apolipoprotein E polymorphisms predict low density lipoprotein cholesterol levels and carotid artery wall thickness but not incident coronary heart disease in 12,491 ARIC study participants.

Elevated levels of low density lipoprotein (LDL) cholesterol is a well-established risk factor for cardiovascular disease, and recent advancements have provided evidence that carotid artery intima-media thickness (IMT) is associated with increased occurrence of cardiovascular events. Apolipoprotein E (ApoE) has been widely studied in regard to its role in lipid transport and metabolism, but the role that ApoE genetic variation plays in relation to carotid artery IMT and risk of incident coronary heart disease remains a subject of debate. In 1987-2001, the authors examined the effect of each ApoE allele (epsilon2, epsilon3, epsilon4) on LDL cholesterol and carotid IMT, as well as the association with coronary heart disease risk, in 12,491 participants of the US Atherosclerosis Risk in Communities Study.

Retinal vascular caliber, cardiovascular risk factors, and inflammation: the multi-ethnic study of atherosclerosis (MESA).

Purpose: To describe the relationship of retinal arteriolar and venular caliber with cardiovascular risk factors, including inflammatory biomarkers, in a multiethnic population of whites, blacks, Hispanics, and Chinese.

Methods: A cross-sectional study comprising 5979 persons aged 45 to 84 years residing in six U.S.

HbA1c and peripheral arterial disease in diabetes: the Atherosclerosis Risk in Communities study.

Objective: To assess the relation between HbA(1c) (A1C) and incident peripheral arterial disease (PAD) in a community-based cohort of diabetic adults from the Atherosclerosis Risk in Communities (ARIC) study. A second aim was to investigate whether the association was stronger for severe, symptomatic disease compared with PAD assessed by low ankle-brachial index (ABI).

Research Design And Methods: This was a prospective cohort study of 1,894 individuals with diabetes using ARIC visit 2 as baseline (1990-1992) with follow-up for incident PAD through 2002.

Diabetic retinopathy in a multi-ethnic cohort in the United States.

Purpose: To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites, blacks, hispanics, and chinese.

Design: Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes, participating in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods: Retinal photographs were obtained with a 45 degrees nonmydriatic digital fundus camera.

Confounding of the relation between homocysteine and peripheral arterial disease by lead, cadmium, and renal function.

Homocysteine levels are associated with peripheral arterial disease (PAD) in observational studies. Lead and cadmium are risk factors for PAD that affect thiol metabolism, and they may partly explain the association of homocysteine with PAD. To evaluate the roles of lead and cadmium exposure in confounding the association between homocysteine and PAD, the authors performed a cross-sectional study among 4,447 persons aged > or = 40 years who participated in the 1999-2002 National Health and Nutrition Examination Survey (NHANES).

Soluble intracellular adhesion molecule-1 is associated with cardiovascular disease risk and mortality in older adults.

Background: Intracellular adhesion molecule-1 (ICAM-1) regulates leukocyte-endothelial attachment, a process crucial to atherosclerosis. Circulating soluble ICAM-1 (sICAM-1) may serve as a marker of cardiovascular disease (CVD) progression.

Objectives: We examined the association of sICAM-1 with measures of subclinical CVD and risk of incident CVD events and death in older men and women (age > or = 65 years) from the Cardiovascular Health Study.

Apolipoprotein E gene and early age-related maculopathy: the Atherosclerosis Risk in Communities Study.

Objective: To examine the association between the apolipoprotein E (APOE) gene and early age-related maculopathy (ARM) in middle-aged persons.

Design: Population-based cross-sectional study.

Participants: Participants from the Atherosclerosis Risk in Communities Study (n = 10139; age range, 49-73 years).

C-reactive protein is a marker for human immunodeficiency virus disease progression.

Background: Limited data on acute-phase C-reactive protein (CRP) levels in human immunodeficiency virus (HIV) infection exist.

Methods: We obtained a single measurement of CRP from 513 HIV-infected men in the Multicenter AIDS Cohort Study to examine the association between CRP and immune suppression and progression to AIDS. We estimated changes in CRP during the course of HIV infection in 81 of these individuals using specimens collected from October 1, 1984, to December 31, 1996.

Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study.

Background: Measurement of inflammatory markers has been reported to identify individuals at increased risk for ischemic stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a proinflammatory enzyme secreted by macrophages. We assessed Lp-PLA2 and C-reactive protein (CRP) levels along with traditional risk factors to examine their relation to ischemic stroke.

Retinal microvascular abnormalities and MRI-defined subclinical cerebral infarction: the Atherosclerosis Risk in Communities Study.

Background And Purpose: Retinal microvascular abnormalities reflect cumulative small vessel damage from elevated blood pressure and may reflect subclinical cerebral microvascular changes. We examined their associations with MRI-defined cerebral infarcts.

Methods: Population-based, cross-sectional study of 1684 persons 55 to 74 years of age without a history of clinical stroke, sampled from 2 US southeastern communities.

Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study.

Background: Individuals with diabetes have a raised risk of stroke, but it is unclear whether sustained hyperglycaemia contributes to the development of cerebrovascular disease. Haemoglobin A1c (HbA(1c)), a measure of long-term glycaemia, is strongly related to retinopathy, nephropathy, and neuropathy in diabetes. We sought to assess the association between HbA(1c) and stroke in people with and without diabetes.

Plasma MCP-1 level and risk for peripheral arterial disease and incident coronary heart disease: Atherosclerosis Risk in Communities study.

Monocyte chemoattractant protein-1 (MCP-1), which mediates the recruitment of monocytes, has been suggested to play a role in atherosclerosis. Because the correlation between circulating MCP-1 and cardiovascular risk has not been thoroughly investigated, we determined the relationship between MCP-1 level and peripheral arterial disease (PAD) or coronary heart disease (CHD). In the Atherosclerosis Risk in Communities (ARIC) study, 209 cases with lower extremity PAD and 412 cases with incident CHD were compared with 733 and 709 subjects without PAD and CHD, respectively.

Arsenic exposure and cardiovascular disease: a systematic review of the epidemiologic evidence.

Arsenic exposure is a likely cause of blackfoot disease and a potential risk factor for atherosclerosis. The authors performed a systematic review of the epidemiologic evidence on the association between arsenic and cardiovascular outcomes. The search period was January 1966 through April 2005.

Cardiovascular risk factors and cerebral atrophy in a middle-aged cohort.

Background: Because cardiovascular (CV) risk factors have been associated with declines in cognitive functions and late life dementia, CV risk factors should also be associated with brain atrophy.

Objective: To study the association of CV risk factors with ventricular size (VS) and sulcal size (SS) in the middle-aged and young-elderly Atherosclerosis Risk in Communities (ARIC) Study cohort.

Methods: Cerebral MRI was performed on 1,812 individuals (aged 50 to 73 [mean 62.

Smoking, diabetes, and blood cholesterol differ in their associations with subclinical atherosclerosis: the Multiethnic Study of Atherosclerosis (MESA).

Previous reports suggest that low-density lipoprotein cholesterol (LDLc) is associated with atherosclerosis plaque initiation while cigarette smoking is more associated with plaque progression. The role of diabetes in plaque initiation and progression is not clear. The aim of this study was to confirm and extend these findings.