Article Text
Abstract
Background/aim To estimate the incidence and risk of major adverse cardiovascular events (MACEs), including heart failure and ischaemic heart disease, among middle-aged people with a visual disability (VD).
Methods We used a national health insurance research database to conduct a population-based cohort study from 1 January 2000 to 31 December 2013. Patients with VD aged 35~65 years were recruited. For each VD patient, five age-matched, sex-matched and comorbidity-matched patients were randomly selected and recruited as controls. Control patients had no documented disability.
Results This study recruited 978 patients with VD (mean age±SD, 55.1±7.8 years; 48.9% male) and 4677 controls. Compared with the same sex of the controls, women with VD had higher incidence of MACE 1 (7.9 vs 2.8/1000 person-years, p<0.001), MACE 2 (27.5 vs 16.9/1000 person-years, p<0.001), MACE 3 (3.7 vs 1.4/1000 person-years, p<0.005) and MACE 4 (4.5 vs 2.5/1000 person-years, p<0.05), and men with VD had higher incidence of MACE 1 (4.6 vs 2.0/1000 person-years, p<0.005). Compared with the controls, patients with VD had lower cumulative MACE 1~MACE 4-free probabilities and had an independently higher risk of MACE 1~MACE 4 during the 13-year study, yielding an adjusted hazard ratio range of 1.31~2.75. Those persons with VD who had diabetes and hypertension had greater risks of MACE 1~MACE 4.
Conclusions Middle-aged adults with VD were at risk of MACEs. A programme for MACE prevention is important for middle-aged people with VD. This is especially true for women and for those who also have diabetes and hypertension.
- vision disability
- heart failure
- ischemic heart disease
- incidence
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Footnotes
Contributors C-MH: analysis and interpretation of data, drafting the article, final approval of the version to be published. J-HW: acquisition and analysis of data, drafting the article, final approval of the version to be published. J-SY: interpretation of data, reviewing and revising the article, final approval of the version to be published. C-HW: analysis and interpretation of data, reviewing and revising the article, final approval of the version to be published. T-HL: conception and design of the study, reviewing and revising the article, final approval of the version to be published. K-HC: conception and design of the study, interpretation of data, reviewing and revising the article, final approval of the version to be published.
Funding This study was supported by the Social and Family Affairs Administration, Ministry of Health and Welfare (grant no 104037), Taipei, and Wan Fang Hospital (grant no 103-wf-eva-28), Taipei Medical University, Taipei, Taiwan.
Competing interests None declared.
Patient consent Not required.
Ethics approval The Joint Institutional Review Board of Taipei Medical University approved this study.
Provenance and peer review Not commissioned; externally peer reviewed.
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