[tabi] link between heart disease and vision loss

  • From: Chip Orange <Corange@xxxxxxxxxxxxxxx>
  • To: "tabi@xxxxxxxxxxxxx" <tabi@xxxxxxxxxxxxx>
  • Date: Tue, 26 May 2015 14:15:24 +0000

From
http://bottomlinehealth.com/if-you-have-heart-disease-you-may-have-silent-macular-degeneration/?spMailingID=48729160&spUserID=NTE4NTUwNTU1NDIS1&spJobID=683043676&spReportId=NjgzMDQzNjc2S0

WHAT YOUR HEART HAS TO SAY ABOUT YOUR EYES

Researchers have long suspected that there's a link between heart disease and
age-related macular degeneration (AMD). The two diseases share many risk
factors beyond simply age-smoking, high blood pressure, high blood cholesterol
levels, diabetes and obesity. But research attempting to connect the dots
between these risk factors and the two diseases has been inconsistent. One
study found an association with stroke but not coronary heart disease, while
another found an association with coronary heart disease but not stroke.

A new study from "down under" used a more powerful measure than risk
factors-clinical evidence of the extent and severity of coronary heart disease.
The Australian researchers carefully studied the eyes of men and women with
suspected heart disease who were already scheduled to have an angiogram. The
results have implications both for early diagnosis and prevention of AMD.

EARLY SIGNS OF A LEADING CAUSE OF BLINDNESS

While the more than 1,600 subjects ranged in age from 23 to 92, the average age
of those who had coronary heart disease was just over 60. By contrast, the late
stage of macular degeneration that actually causes vision symptoms (problems
with ability to see fine detail, reading and driving and eventually even seeing
faces) often doesn't occur until people reach their late 70s or early 80s.
Early macular degeneration, and often the intermediate stage, has no symptoms,
although it can be detected by a comprehensive eye exam. By the time that
vision is impaired, it's harder to treat.


The men and women in the study all had
coronary angiography
, a procedure in which dye injected into a catheter shows how blood flows
through the arteries to the heart. The angiograms allowed cardiologists to take
precise measurements to grade the severity of blockage in the coronary
arteries. Severity was quantified two ways-first by the number of vessels with
significant obstruction, and then by using a
Gensini score
, a more sophisticated calculation that places emphasis on the more important
artery segments. The participants also had their eyes checked out very
carefully for signs of AMD.

Results:
About 6% of the men and women had early AMD and 1.4% had late AMD. Those who
had serious artery blockage were
much
more likely to have early AMD. After adjusting for age, gender, body mass
index, smoking, diabetes and other risk factors, the participants with a
narrowing of more than 50% in any one artery segment were
nearly twice as likely to have early AMD
compared with participants without artery narrowing. Those with narrowing in
all three main coronary arteries were
2.7 times more likely to have early AMD
. The Gensini score was also highly associated with early AMD-participants with
the highest Gensini scores were more than twice as likely as those with the
lowest scores to have early AMD.

There were some differences between men and women, too, another indication that
heart disease affects the genders differently. For women, there was no link
between artery blockage and early AMD, but those with the highest Gensini score
were
five times
more likely to have early AMD. More research is needed to understand how
coronary artery disease affects the genders differently and how this relates to
early AMD risk, the researchers conclude. But clearly there was risk for both
genders.

A CLEAR AND PRESENT DANGER

The take-away messages from this study couldn't be clearer...

* If you or someone you know has coronary heart disease, don't wait to get your
eyes checked. According to the
Agency for Healthcare Research and Quality
, all adults with no risk factors should have a comprehensive eye exam (which
includes AMD testing) every five to 10 years. Those aged 40 to 54 may need to
have it repeated only every two to four years...aged 55 to 64, every one to
three years...those 65 and over, every one to two years. That's fine for the
general population, but this study suggests that people with heart disease
should be checked immediately-and ask their doctor how often they should get
rechecked.

* Go to your optometrist, ophthalmologist or retina specialist for a
comprehensive eye exam. While many (not all) optometrists do screen for signs
of AMD, opthamologists, (including those who are retina specialists) generally
have much more sophisticated equipment. So you may be referred to one if an eye
exam finds something suspicious. Opticians generally don't screen for AMD.

* There's no cure for this sight-robbing disease, but the process can be slowed
down with a heart-healthy lifestyle and supplements, and it needs to be
monitored so that when it does need treatment in the late stage, that starts
right away.

* If you have both conditions, make sure your cardiologist and your eye
specialist both know all of the medications and supplements you are taking.
Blood thinners-prescription medications as well as aspirin and fish oil, for
example-may cause bleeding problems, including in your eyes, that could make
vision problems worse.

The new research also reinforces that a healthy lifestyle is important for the
prevention of a wide variety of age-related diseases. Preventing macular
degeneration is about more than just taking the right
vitamins
.
According to the American Academy of Ophthamology, other eye diseases that are
related to cardiovascular health include cataracts and retinopathy, often found
in people with diabetes. Take
care of your heart
and you may be taking care of your eyes, too.



Source:
Study titled "Severity of coronary artery disease is independently associated
with the frequency of early age-related macular degeneration" by researchers in
the department of ophthalmology, Centre for Vision Research, Westmead
Millennium Institute, U niversity of Sydney, and
Westmead Hospital, Australia, published in
British Journal of Ophthalmology.



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