Project 445066

More than two hundred thousand people suffer from heart attack or stroke every year in Canada. This number continues to grow despite drug developments to treat diabetes, hypertension, high cholesterol and obesity. Vascular diseases that affect arteries in the heart and brain are, in fact, the advanced stage of a progressive vessel alteration that begins by silently affecting the very small vessels of the body. A better understanding of mechanisms altering the small vessels would provide earlier and improved risk prediction for heart attacks and strokes, and would help identify new drug targets for these diseases. Retinal images can be used to assess an individual's overall small vessel condition for three reasons: (1) retinal vessel images are an easily observable part of an individual's small vessel abnormalities using ocular fundus photographs; (2) retinal vessel architecture is affected by diabetes, hypertension, high cholesterol, obesity, and smoking; and (3) retinal vessel changes can predict the occurrence of heart attacks and strokes. By combining advanced method to analyze genes and blood proteins with artificial intelligence programs to read retina images, in large populations (Canadian Longitudinal Study on Aging, UK Biobank, Prospective Urban Rural Epidemiology study), we will identify genes and proteins involved in small vessel diseases. Those findings will help discover new biological mechanisms and druggable targets to maintain small vessels healthy, and thus early prevent the occurrence of cardiovascular diseases. We will also test whether automated retinal screening can be used to improve the prediction of heart attacks and strokes. Our findings will improve risk assessment, prevention strategies, and will guide future clinical trials for cardiovascular diseases. This study will also provide targets for effective lifestyle and pharmacological interventions for small vessel changes, and in fine, to decrease heart attacks and strokes.