Quantitative Retinal Venular Caliber and Risk of Cardiovascular Disease in Older Persons

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Abstract
Cardiovascular disease is a leading cause of death in persons aged 65 years or older in the United States.1 Traditional risk factors do not have the same predictive value in older persons2-8 and, thus, identification of new risk factors is important. There is increasing recognition that small vessel disease (microvascular disease) may have a possible pathophysiologic role in the development of both subclinical and clinical cardiovascular disease.9-11 Microvascular disease affecting cerebral arterioles, for example, is linked to a large proportion of subclinical and lacunar strokes defined at magnetic resonance imaging,12-14 whereas coronary microvascular dysfunction may explain the occurrence of myocardial ischemia in persons without overt coronary artery occlusion.15,16 Most studies of microvascular disease have been conducted in small numbers of patients with symptomatic disease in specialized laboratory settings,10,11 and few have been conducted in older persons.