A healthy lifestyle for cardiovascular health also promotes good eye health

This new study found that ideal cardiovascular health, indicative of a healthy lifestyle, was associated with lower odds for developing ocular diseases, particularly diabetic retinopathy, reports The American Journal of Medicine


Philadelphia, August 20, 2020

In a new study, investigators found that ideal cardiovascular health, which is indicative of a healthy lifestyle, was associated with lower odds for ocular diseases especially diabetic retinopathy. These findings appearing in The American Journal of Medicine, published by Elsevier, suggest that interventions to prevent cardiovascular diseases may also hold promise in preventing ocular diseases.

Globally, about 2.2 billion people suffer from ocular diseases leading to vision impairment or blindness. Approximately half of these cases could have been prevented. The leading causes of vision impairment or blindness are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma.

“Earlier studies have observed associations between eye diseases and individual lifestyle factors such as smoking, obesity, or hypertension,” explained lead investigator Duke Appiah, PhD, MPH, Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA. “It is known that these metrics of ideal cardiovascular health do not work alone and may interact additively to result in diseases. However, prior to our research, no other studies have comprehensively evaluated the association of all of the metrics of ideal cardiovascular health with ocular diseases.”

Most ocular diseases show few symptoms at early stages and many people may not seek medical care despite readily available treatments. A recent online nationwide survey consisting of all racial and ethnic groups in the United States conducted by the Wilmer Eye Institute at Johns Hopkins University School of Medicine showed that 88 percent of the 2,044 respondents considered good vision to be vital to overall health with 47 percent of them rating losing their vision as the worst disease that could ever happen to them. Alarmingly, 25 percent did not have any knowledge about ocular diseases and their risk factors.

This research shows that following healthy lifestyle and behavior habits can all contribute to good cardiovascular health as assessed by adherence to the American Heart Association's prescription for health metric known as Life’s Simple Seven (LS7). LS7 is based on the status of seven cardiovascular disease risk factors: not smoking, regular physical activity, healthy diet, maintaining normal weight, and controlling cholesterol, blood pressure, and blood glucose levels.

Practicing these healthy lifestyles together was found to be associated with lower odds for age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Individuals with optimal cardiovascular health had 97 percent lower odds for diabetic retinopathy compared to individuals with inadequate cardiovascular health.

Investigators evaluated data from 6,118 adults aged 40 or more years old who took part in the 2005-2008 National Health and Nutrition Examination Survey. The average age of participants was 57 years old, 53 percent of whom were women. A one unit increase in LS7 scores was associated with reduced odds for age-related macular degeneration, diabetic retinopathy, and glaucoma.

Cross-section image of a normal retina vs retina with diabetic retinopathy. Credit: Mayo Foundation for Medical Education and Research, All Rights Reserved.
Normal Retina vs. Retina with Diabetic Retinopathy. Credit: Mayo Foundation for Medical Education and Research, All Rights Reserved.

“Overall, we believe that primary prevention and early detection approaches of ocular diseases are important, considering that over half of all deaths from ocular diseases and cardiovascular diseases are known to be preventable,” commented co-investigators Noah De La Cruz, MPH, and Obadeh Shabaneh, MPH, both from the Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Since there is a significant overlap of the risk factors for ocular diseases and cardiovascular disease, the investigators recommended that screening for ocular diseases be incorporated into existing clinical and population-based screenings for cardiovascular diseases.

“We hope that our study findings will encourage adherence to healthy lifestyles in order to prevent these age-related diseases while also leading to increased collaborations between cardiologists, optometrists, and ophthalmologists in order to better prevent cardiovascular and ocular diseases,” noted Dr. Appiah.

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Notes for editors
The article is “The Association of Ideal Cardiovascular Health and Ocular Diseases Among US Adults,” by Noah De La Cruz, MPH; Obadeh Shabaneh, MPH; and Duke Appiah, PhD, MPH (https://doi.org/10.1016/j.amjmed.2020.06.004). It appears in advance of The American Journal of Medicine volume 134, issue 2 (February 2021) published by Elsevier,

Data collection for the publicly available data used for this study was funded by US Centers for Disease Control and Prevention.

Full text of this article is also available to credentialed journalists upon request. Contact Jane Grochowski at +1 406 542 8397 or hmsmedia@elsevier.com to obtain copies. Journalists who would like to interview the study authors should contact Duke Appiah, PhD, MPH, at +1 806 743 9472 or duke.appiah@ttuhsc.edu.

About The American Journal of Medicine
The American Journal of Medicine, known as the “Green Journal,” is one of the oldest and most prestigious general internal medicine journals published in the United States. The official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at 125-plus US medical schools, AJM publishes peer-reviewed, original scientific studies that have direct clinical significance. The information contained in this article in The American Journal of Medicine is not a substitute for medical advice or treatment, and the Journal recommends consultation with your physician or healthcare professional. www.amjmed.com

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. www.elsevier.com

Media contact
Jane Grochowski, Publisher
Elsevier
+1 406 542 8397
hmsmedia@elsevier.com