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Incidence and risk of major heart diseases in middle-aged adults with moderate to severe vision impairment: a population-based cohort study
  1. Chun-Mei Hsueh1,
  2. Jing-Hwa Wey2,
  3. Jong-Shiuan Yeh3,
  4. Chien-Hua Wu4,
  5. Tsan-Hon Liou5,6,7,
  6. Kwang-Hwa Chang2,6,7
  1. 1 Department of Ophthalmology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
  2. 2 Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
  3. 3 Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
  4. 4 Department of Applied Mathematics, Chung-Yuan Christian University, Taoyuan, Taiwan
  5. 5 Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
  6. 6 Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
  7. 7 Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Kwang-Hwa Chang, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan; chang2773{at}gmail.com

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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