Is Cataract Associated with Cardiovascular Morbidity?

From Eye

AY Nemet; S Vinker; S Levartovsky; I Kaiserman

Abstract

Aims To evaluate the prevalence of cardiovascular disease (CVD) and its risk factors among patients undergoing cataract surgery.

Methods A retrospective observational case–control study of all the members older than 50 years who underwent cataract surgery in the Central District of Clalit Health Services in Israel (years 2000–2007) (n=12 984) and 25 968 age- and gender-matched controls. We calculated the prevalence of CVDs' and their risk factors, including carotid artery disease (CAD), peripheral vascular disease (PVD), systemic arterial hypertension (HTN), chronic renal failure (CRF), ischaemic heart disease (IHD), congestive heart failure, diabetes, smoking, alcohol abuse, and hyperlipidaemia. The main outcome measures were the odds ratio of having CVDs among cataract patients undergoing surgery compared with controls.

Results No difference was found in demographics (age, gender, marriage status, socioeconomic class, and living place) between the study and control groups. All CVDs' risk factors were significantly more prevalent in cataract patients in univariate analysis. Multivariate logistic regression analysis revealed a significant association of the following with cataractogenesis: diabetes, CAD, HTN, PVD, smoking, IHD, CRF, hyperlipidaemia, and Ashkenazi origin.

Conclusions CVDs and their risk factors are more prevalent among cataract patients undergoing cataract surgery.

Introduction

It is generally acknowledged that age-related (senile) cataract is a multifactorial disease. Epidemiologic studies of this disease have suggested many risk factors for cataract.[1] Diabetes, glaucoma, several analgesics, myopia, renal failure, smoking, heavy alcohol consumption, hypertension (HTN), low body mass index, use of cheaper cooking fuel, working in direct sunlight, family history of cataract, occupational exposure, and several biochemical factors are just a partial list of the potential risk factors for cataract.[2] Interactions among the risk factors can mask the real contribution of each in the development of the diseases. An intriguing link between development of age-related cataracts and increased future risk of coronary heart disease has been suggested.[3]

As free radical-mediated oxidative damage to lipoproteins may accelerate atherosclerosis as well as cataract formation,[4] the development of cataract might be a marker for such damage and, therefore, might be associated with an increased risk of coronary heart disease.[3]

Although some studies support the association of cataract and cardiovascular diseases (CVDs),[5] other studies reporting cataract risk factors do not mention CVD. Klein et al [6] in the Beaver Dam Eye study reported that CVDs and their risk factors have little effect on the incidence of age-related cataract.

This study aims to evaluate the prevalence of cardiovascular morbidity among 12 984 cataract patients undergoing cataract surgery in Israel.