Retinopathy severity linked to cardiovascular outcome

Hertzel C. Gerstein, M.D., of McMaster University in Hamilton, Canada, and colleagues examined the correlation between retinopathy, four-year progression, and cardiovascular outcomes (cardiovascular death, nonfatal myocardial infarction, or stroke) using data from 3,433 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and ACCORD Eye Study, who had baseline retinal photographs.

The researchers found that the adjusted hazard ratio for cardiovascular outcome increased from 1.49 for mild retinopathy to 2.35 for severe retinopathy, compared with no retinopathy. For a subset of 2,856 participants evaluated for disease progression at four years, for each category of change in retinopathy severity, the risk of the primary outcome increased by 38 percent. The correlation between progression and cardiovascular outcomes was no longer significant after adjustment for the baseline and follow-up levels of glycated hemoglobin, systolic blood pressure, and lipids either individually or together.

"The clear link between progression of retinal disease and cardiovascular disease suggests that these two serious consequences of diabetes may share an underlying pathophysiological basis," the authors write.

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Journal reference: Diabetes Care

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