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Title: Hypertensive/microvascular disease and COPD: a case control study
Austin Authors: Chew, Sky KH;Colville, Deb;Canty, Piers;Hutchinson, Anastasia;Wong, Alex;Luong, Vi;Wong, Tien Y;McDonald, Christine F ;Savige, Judy A
Affiliation: Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
The University of Melbourne Department of Medicine (Northern Health), Epping, Australia
Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Issue Date: Feb-2016 2016-01-08
Publication information: Kidney & Blood Pressure Research 2016; 41: 29-39
Abstract: BACKGROUND/AIMS: This study tested the hypothesis that individuals with chronic obstructive pulmonary disease (COPD) have more small vessel disease and more severe disease than an age- and gender- matched hospital patient comparison group. METHODS: This was a single centre, case-control study of 151 individuals with COPD (FEV1/VC) < 0.7 recruited consecutively immediately after respiratory function tests at a Melbourne teaching hospital over a 4 month period in 2010. Controls were individuals with normal respiratory function tests recruited contemporaneously from the same centre. Retinal images were obtained with a nonmydriatic camera (KOWA or Canon CR5-45NM), deidentiifed and graded by two trained graders for microvascular retinopathy (Wong and Mitchell classification), and vessel calibre using a computer-assisted method and Knudtson's modification of the Parr-Hubbard formula. Differences in microvascular retinopathy and vessel calibre between COPD patients and the comparison group were examined using Fisher's exact test or the t test (StataCorp, Texas). RESULTS: Patients with COPD had more microvascular retinopathy (121, 80% and 76, 50%; OR 3.98, 95%CI 2.39 to 6.64) and more severe disease (42, 28% and 18, 12%; OR 2.85, 95% CI 1.55 to 5.23) than other hospital patients. COPD remained an independent determinant of microvascular retinopathy (OR 4.56, 95%CI 2.49 to 8.36) after adjusting for gender, hypertension, smoking, and diabetes duration. Retinal arterioles and venules were wider in patients with COPD than other hospital patients (mean difference +6.5 µm, 95% confidence interval 1.4 to 11.6; and +17.4 µm, 95%CI 9.4 to 25.5, respectively). Larger venules were more common in younger individuals (+0.6 µm, 0.1 to 1.17) with more cigarette exposure (+0.3 µm, 0.2 to 0.5) or a lower serum albumin (+23.0 µm, 6.0 to 40.0). Venular calibre was not different in current and former smokers (p=0.77). There were trends for venules to be larger with more severe COPD (lower FEV1/VC, p=0.09) and with CT-demonstrated emphysema (p=0.06). CONCLUSIONS: Hypertensive/microvascular disease is more common and more severe in patients with COPD. This is likely to contribute to the associated increase in cardiac risk.
DOI: 10.1159/000368544
ORCID: 0000-0002-6813-0288
PubMed URL:
Type: Journal Article
Subjects: Microvascular retinopathy
Chronic obstructive pulmonary disease
Case-Control Studies
Middle Aged
Pilot Projects
Retinal Diseases
Retinal Vessels
Risk Factors
Appears in Collections:Journal articles

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