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Retinopathy predicts coronary heart disease mortality
1Department of Ophthalmology, Centre for Vision Research, University of Sydney, Westmead Hospital, Westmead, NSW, Australia. jiejin_wang@wmi.usyd.edu.au
Insights
Retinopathy, a common eye condition, independently predicts coronary heart disease (CHD) mortality in both diabetic and non-diabetic individuals. This finding highlights the importance of screening for retinopathy to assess cardiovascular risk.
Area of Science:
- Ophthalmology
- Cardiology
- Public Health
Background:
- Retinopathy lesions are common clinical findings.
- These lesions may indicate an increased risk of coronary heart disease (CHD).
Purpose of the Study:
- To determine if retinopathy independently predicts CHD mortality.
- The study examined this risk in both diabetic and non-diabetic populations.
Main Methods:
- The Blue Mountains Eye Study cohort included 2967 participants (199 with diabetes, 2768 without).
- Retinopathy presence and severity were assessed from retinal photographs.
- Coronary heart disease deaths over 12 years were tracked using the Australian National Death Index.
Main Results:
- Over 12 years, 353 participants (11.9%) died from CHD.
- Retinopathy increased CHD mortality risk similarly to diabetes.
- After adjusting for risk factors, retinopathy independently predicted CHD death in both diabetic (HR=2.21) and non-diabetic (HR=1.33) individuals.
- Moderate retinopathy showed significantly higher adjusted hazard ratios for CHD death in both groups.
Conclusions:
- Retinopathy detection in individuals with or without diabetes signals elevated CHD risk.
- The CHD mortality risk associated with retinopathy in non-diabetics is comparable to having diabetes itself.
Background:
Retinopathy lesions are fairly common findings in clinic settings and may predict risk of coronary heart disease (CHD).
Objective:
To examine whether retinopathy independently predicts a risk of CHD-related mortality in people with and without diabetes.
Methods:
In an Australian population-based cohort of people with (n = 199) and without (n = 2768) diabetes (Blue Mountains Eye Study, total n = 2967), the presence and severity of retinopathy was assessed from retinal photographs. 12-Year cumulative CHD deaths were ascertained from Australian National Death Index records.
Results:
Over 12 years, 353 participants (11.9%) had incident CHD-related deaths. Retinopathy was present in 57/199 (28.6%) participants with, and in 268/2768 (9.7%) without, diabetes. The presence of retinopathy increased the CHD mortality rate per person-year by an amount (0.005) equivalent to the presence of diabetes itself (12-year CHD mortality rate per person-year of 0.010 in people with neither diabetes nor retinopathy, 0.015 in those with diabetes alone, 0.016 in those with retinopathy alone). After adjusting for cardiovascular risk factors, retinopathy remained an independent predictor of CHD death both in people with diabetes (hazard ratio (HR) = 2.21, 95% CI 1.20 to 4.05) and in those without diabetes (HR = 1.33, 95% CI 1.02 to 1.83). Moderate retinopathy was associated with adjusted HR = 6.68 (95% CI 2.24 to 20.0) in people with diabetes and adjusted HR = 2.29 (95% CI 1.10 to 4.76) in people without diabetes.
Conclusions:
A finding of retinopathy in people with or without diabetes may signal increased CHD risk. The increased CHD mortality associated with retinopathy in people without diabetes was equivalent to the presence of diabetes itself.
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