Relationship of retinal vessel caliber to cardiovascular disease and mortality in African Americans with type 1 diabetes mellitus.

Objective: To examine the relationship between retinal arteriolar and venular diameter and the 6-year incidence of cardiovascular disease and mortality among African Americans with type 1 diabetes mellitus.

Methods: Included were 468 African Americans with type 1 diabetes mellitus who participated in the New Jersey 725 and who had undergone a 6-year follow-up examination. At both baseline and 6-year follow-up, hypertension and presence of heart disease, stroke, or lower extremity arterial disease (LEAD) were documented and confirmed by review of hospital admission and medical records. Computer-assisted grading from digitized images of retinal photographs was accomplished to determine the average diameter of retinal arterioles (central retinal arteriolar equivalent) and venules (central retinal venular equivalent). Retinal vessel diameter size was examined in relation to the 6-year incidence of hypertension, any cardiovascular disease (heart disease, stroke, or LEAD), heart disease or stroke, LEAD, and mortality.

Results: Narrower central retinal arteriolar equivalent at baseline significantly and independently predicted 6-year incidence of any cardiovascular disease and LEAD, whereas larger retinal venular diameter at baseline significantly and independently predicted 6-year incidence of hypertension. Proteinuria and retinopathy severity at baseline were stronger predictors of mortality than retinal vascular diameter.

Conclusion: In African Americans with type 1 diabetes mellitus, baseline retinal vessel caliber is an independent predictor of incident hypertension and LEAD.