Sudden Vision Loss and Mortality: The Jackson Heart Study

ABSTRACT

Purpose: It is unknown whether sudden vision loss (SVL) is an independent marker for future cardiovascular disease (CVD) events in African Americans. We examined the hazard of future stroke or myocardial infarction (MI) and mortality associated with self-reported SVL lasting 24 hours or longer in a cohort of African Americans enrolled in the Jackson Heart Study (JHS).

Methods: The study sample comprised 4670 African Americans aged 20–95 years enrolled in the JHS 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. Ten years of follow-up data was used. Cox proportional hazards modeling was used to examine the association between SVL (n = 142) and risk of future stroke/MI and mortality.

Results: In age- and sex-adjusted Cox models, SVL was significantly associated with higher hazards of future stroke/MI (hazard ratio, HR, 2.08, 95% confidence interval, CI, 1.09–3.96) and mortality (HR 1.73, 95% CI 1.07–2.78). After adjusting for diabetes mellitus, total/high-density lipoprotein cholesterol ratio, smoking, hypertension and income, the relationships between SVL and future stroke/MI (adjusted HR 1.51, 95% CI 0.78–2.90) or mortality (adjusted HR 1.29, 95% CI 0.78–2.11) were no longer significant.

Conclusions: Self-reported SVL lasting 24 hours or longer was significantly associated with future stroke/MI and mortality, but its effect is likely a surrogate for underlying CVD risk factors rather than being an independent predictor.

KEYWORDS:

• African Americans
• cardiovascular disease
• Jackson Heart Study
• mortality
• sudden visual loss

Acknowledgment

This research study was orally presented at the 2015 Association for Research in Vision and Ophthalmology conference in Denver, CO on May 4, 2015.

Funding

AJC was supported by a Basic and Translational Research Program Summer Stipend at the Alpert Medical School funded by NIH NHLBI T35HL094308. The JacksonHeart Study is supported by contracts HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Disclaimer

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Additional information

Funding

AJC was supported by a Basic and Translational Research Program Summer Stipend at the Alpert Medical School funded by NIH NHLBI T35HL094308. The JacksonHeart Study is supported by contracts HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities.