MONDAY, April 14 (HealthDay News) -- Diabetic retinopathy, a
leading cause of vision loss in the United States, is also a
warning sign of heart failure, a new study says.
The study followed more than 1,000 middle-aged people with type
2 diabetes for nine years and found that those with retinopathy at
the start had more than a 2.5-fold higher risk of developing heart
failure than those without retinopathy.
The finding was published in the April 22 issue of the
Journal of the American College of Cardiology.
"They have made the point that patients with diabetic
retinopathy need to be more vigilant in looking for the development
of heart failure," said Dr. Hector O. Ventura, director of the
cardiology residency program at the Ochsner Health System in New
Orleans, and co-author of an accompanying editorial in the
journal.
The physical connection between retinopathy -- which is caused
by leakage and/or overgrowth of tiny blood vessels in the eye --
and heart failure -- which is the progressive loss of the ability
to pump blood -- is not clear, Ventura said. But the new study
strengthens evidence for such a link, he said.
A relationship between diabetic retinopathy and an increased
risk of heart failure was first described two decades ago in the
long-running Framingham Heart Study, which follows residents of a
Massachusetts city, the journal report noted.
A number of later studies found a similar relationship. The
research team behind the new study, an international group with
members in Australia, Singapore and the United States, described
the retinopathy-heart failure association in detail two years ago
in a study of people with diabetes in four communities.
The new study singled out retinopathy as a heart risk factor by
selecting participants who were free of kidney disease and coronary
heart disease, two major risk factors for heart failure.
Just 125 of the participants had diabetic retinopathy at the
start of the study. After nine years, heart failure was diagnosed
in 27 of them, an incidence of 21.6 percent. The incidence in those
without the eye condition was 8.5 percent.
Guidelines for treatment of retinopathy do not mention heart
failure, but perhaps they should, Ventura said. "Maybe the
guidelines one day will say that if you have retinopathy, you
should see a cardiologist," he said.
It's possible that the same kind of trouble with the eyes'
microvasculature -- the tiniest blood vessels -- can also have an
effect on the heart over the decades, the study authors said.
Retinopathy could be an indicator of inflammation and other
damage to the endothelium, the delicate inner lining of blood
vessels, Ventura said.
Dr. Nancy Sweitzer, director of the heart failure program at the
University of Wisconsin, said, "The interesting thing about this
study was that the association was as strong for mild degrees of
eye disease as for strong degrees. It has to be taken very
seriously."
While the study doesn't break new ground, she said, "no one has
ever looked in such a detailed way at the association between
disease in microvessels and heart failure."
Cardiologists have become more concerned about the coronary
effects of diabetes in recent years, and people with diabetes
should act on that concern, Sweitzer said. "They should talk to
their doctor about diabetes in general, not just about
retinopathy," she added.
More information
Learn more about diabetic retinopathy from the
U.S. National Eye Institute.
