The Risk of Cardiovascular Disease Risk Among Adults with Vision Impairment from Low-, Middle- and High-Income Countries

ABSTRACT

Purpose

The limited evidence for cardiovascular disease (CVD) among adults with vision impairment (VI) has often been from developed countries using self-reported VI. This study evaluated the association of objectively-determined VI with the risk of CVD among adults from low-, middle-, and high-income countries.

Methods

Data were from 32,268 adults aged 30–74 years without CVD or blindness from China, Ghana, India, Mexico, Russian Federation, South Africa, and the United States during 2007–2010. VI and severe VI was defined as presenting visual acuity worse than 6/18, and 6/60, respectively. The Framingham risk algorithm was used to estimate the risk for incident CVD. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals.

Results

The mean age of participants was 46.4 years, with half of them being women (49.3%). The age-adjusted prevalence of VI ranged from 1.1% (United States) to 14.2% (South Africa) while severe VI ranged from 0.4% (United States) to 4.5% (Ghana). In models adjusting for country, sociodemographic factors, waist girth, healthcare use, activities of daily living and other health-related factors, VI was associated with CVD risk ≥ 10% (OR = 1.69, 95% CI: 1.22–2.36). This observed association was largely consistent across countries (p = 0.119). The observed CVD risk was similar among adults with moderate or severe VI (OR = 0.95, 95% CI: 0.50–1.83). CVD risk was higher among adults with VI who were <65 years old (OR = 1.89, 95% CI: 1.36–2.63) or were employed (OR = 2.24, 95% CI: 1.58–3.16).

Conlusions

This cross-national study shows that individuals with VI are at high risk for future CVD.

KEYWORDS:

• Aging
• cardiovascular disease
• developing countries
• epidemiology
• vision impairment

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

This report used data from WHO Study on Global Ageing and Adult Health (SAGE).

Wave 1 which are available at https://www.who.int/data/data-collection-tools/study-on-global-ageing-and-adult-health as well as the National Health and Nutrition Examination Survey (NHANES) and are publicly available through the Centers for Disease Control and Prevention: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2007.

Financial support

None of the following authors have any proprietary interests or conflicts of interest related to this submission

Statement

We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.