Diabetic retinopathy and risk of heart failure

In diabetics, a common eye condition called retinopathy more than doubles the risk of heart failure. In diabetic retinopathy the small blood vessels of the retina become weakened and develop small outpouchings called microaneurysms. These vessels also become more permeable, that is, proteins and other substances readily leak out through the walls of the blood vessels. In the later stages, these blood vessels may get completely blocked. Due to the diseased vessels, the retina is deprived of adequate oxygen supply and this stimulates growth of new, abnormal vessels in the retina. To better understand this association, Australian researchers analysed data from 1,021 adults with type 2 diabetes who were without heart or kidney disease when the study began. Nearly 13 per cent of the patients did, however, have diabetic retinopathy. During nine years of follow-up, about 10 per cent of the patients developed heart failure. Overall, nearly 22 per cent of patients with retinopathy developed heart failure compared with just 8.5 per cent of those without retinopathy. After accounting for other factors that may have influenced the association, diabetic retinopathy increased the risk of heart failure by 2.2-fold. Current guidelines already identify the need for routine screening for retinopathy in the diabetic patient. In addition to appropriate vision care, the detection of retinopathy might now also warrant a fuller cardiac evaluation and closer follow-up to prevent the development of heart failure.

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