ABSTRACT
Purpose
Visual impairment (VI) is highly prevalent in the elderly and is associated with functional decline. Previous research demonstrated an association between VI and cardiovascular events, but investigations have yet to be conducted in general population samples. We evaluated the relationship between visual acuity (VA) and development of cardiovascular diseases (CVD) in a nationwide Korean population.
Methods
This is a nationwide retrospective cohort study. We used the National Health Information Database of the National Health Insurance Service of Korea to identify subjects who participated in the National Health Insurance Service health screening program in 2012. We monitored 5,941,761 subjects for the development of cardiovascular diseases for a period of 5 years.
Results
After adjustments for age, sex, and other covariates, with subjects having a visual acuity better than 20/20 as the reference group, the adjusted hazard ratios (HRs) and 95% confidential intervals (CI) for acute myocardial infarction and stroke were visual acuity between 20/20 and 20/60, 1.073 (95% CI 1.053, 1.094) and 1.151 (95% CI 1.132, 1.171), respectively; for visual acuity between 20/60 and 20/200, 1.236 (95% CI 1.197, 1.277), and 1.336 (95% CI 1.302, 1.371), respectively; and for visual acuity worse than 20/200, 1.325 (95% CI 1.285, 1.366) and 1.383 (95% CI 1.349, 1.418), respectively.
Conclusion
Subjects with lower VA had higher risks of acute myocardial infarction and stroke. These results suggest that low VA is an independent risk factor for CVD.
Abbreviations
AMI, acute myocardial infarction; BP, blood pressure; BMI, body mass index; CI, confidential interval; CVD, cardiovascular disease; NHID, National Health Information Database; NHIS, National Health Insurance Service; DBP, diastolic blood pressure; HDL, high-density lipoprotein; HR, hazard ratios; CI, confidence interval; ICD, International Classification of Diseases; KCD, Korean Classification of Diseases; LDL, low-density lipoprotein; PA, physical activity; SBP, systolic blood pressure; TC, total cholesterol; TG, triglyceride; VI, visual impairment; WC, waist circumference.
Authors’ contributions
Conception and design: Dong Hui Lim, Kyung-Shun Na
Data acquisition: Dong Hui Lim, Kyung-Shun Na
Data analysis and interpretation: Kyungdo Han
Drafting the manuscript: Gyule Han, Jisang Han
Critique and revision of manuscript: Jisang Han, Dong Hui Lim, Tae-Young Chung
Final approval of manuscript to be published: Dong Hui Lim, Kyung-Shun Na.
Conflicts of interest
None of the following authors have any proprietary interests or conflicts of interest related to this submission.
Data availability
The data used in this study are not available to other researchers because it is secured national data which only researchers who have permission from the Korean government can assess.
* Gyule Han and Jisang Han contributed equally to the article as the first authors.
† Dong Hui Lim and Kyung-Shun Na are co-corresponding authors of this study.