Cardiovascular Effects of Diabetic Retinopathy in Patients with Type 2 Diabetes

Electrocardiogram or EKG with a stethoscopeThough prior research has demonstrated an association between diabetic retinopathy (DR) and risk of cardiovascular disease in patients with diabetes, a team led by researchers in Japan explored whether the severity of the DR may affect coronary heart disease or stroke risk in patients living with type 2 diabetes.

Their study, “Risk of cardiovascular diseases is increased even with mild diabetic retinopathy: The Japan diabetes complications study,” was published online ahead of print in November 2012. It appears in the journal Ophthalmology.

The researchers relied on data from the Japan Diabetes Complications Study. The study included information on 2,033 people with type 2 diabetes. None of the participants had cardiovascular diseases at the onset of the study.

The researchers used international clinical diabetic retinopathy and diabetic macular edema disease scales to determine the presence and extent of diabetic retinopathy in the study participants. Additionally, they measured the prevalence of coronary heart disease and stroke up to 8 years following the start of the study. The researchers were interested in the 8-year incidence of heart problems in patients with diabetic retinopathy, compared to people without the condition.

The results showed that patients who had mild to moderate diabetic retinopathy had a higher risk for coronary heart disease and stroke. These findings held after the researchers controlled for other cardiovascular risk factors. Patients who had retinal hemorrhages or microaneurysms had a higher risk of coronary heart disease, but not stroke. However, patients who had cotton-wool spots had a higher risk of stroke, but not coronary heart disease.

The study authors conclude that their findings demonstrate an association between cardiovascular disease and even mild or moderate diabetic retinopathy in patients with type 2 diabetes.  This heightened risk of cardiovascular problems, like coronary heart disease and stroke, exists independent of traditional risk factors.

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