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Allison J Chen, Wen-Chih Wu, Paul B Greenberg; Sudden visual loss and mortality: the Jackson Heart Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2030.
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Sudden visual loss (SVL) is associated with cardiovascular disease (CVD) risk factors and diabetes mellitus (DM) in African Americans (AAs), but it is unknown whether SVL is an independent marker for future CVD events. We examined herein the hazard of future myocardial infarction (MI) or stroke and mortality associated with self-reported SVL lasting 24 hours or longer in the cohort of AAs enrolled in the Jackson Heart Study (JHS).
The study population comprised the cohort of 5,301 AAs enrolled from 2000-2004 in the JHS, the largest population-based observational study of CVD and DM in AAs, without previous coronary heart disease or stroke at baseline. All participants who responded to the question “Have you ever had any sudden loss of vision or blurring, lasting 24 hours or longer?” on the baseline stroke questionnaire were included in the study. We used cox proportional hazards modeling to examine the association between SVL and risk of future MI or stroke and mortality.
There were 4704 participants included, ages 21-84, of which 64% (3041/4704) were female. In age and gender-adjusted Cox models, SVL was significantly associated with higher hazards of future stroke/MI (HR=2.17, 95% CI, 1.14-4.13) and mortality (HR = 1.82, 95% CI 1.13-2.94). After adjusting for DM, total cholesterol/HDL ratio, smoking, hypertension, and income, the relationship between SVL and future stroke/MI or with mortality was no longer<br /> significant.
Self-reported SVL lasting 24 hours or longer is significantly associated with future MI/stroke and mortality, but its effect is likely a surrogate for having underlying CV risk factors rather than being an independent predictor. This finding underscores the importance of looking for underlying CVD/risk factors in patients who have self-reported SVL to enable early intervention, which may prevent future stroke/MI or mortality.
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