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Abstract #99333 Published in IGR 22-4
Association between retinal vein occlusion and Life's Simple 7 cardiovascular health metrics: A large claims database study
Hashimoto Y; Kaneko H; Okada A; Matsui H; Yasunaga H; Aihara M; Obata ROphthalmology. Retina 2022; 6: 684-692
PURPOSE: Cardiovascular diseases and retinal vein occlusion (RVO) share many risk factors in common. We aimed to investigate the association between RVO occurrence and cardiovascular health (CVH) metrics known as Life's Simple 7, which is an indicator of an unhealthy lifestyle. DESIGN: Retrospective cohort study. PARTICIPANTS: Individuals in the JMDC Claims Database (JMDC Inc., Tokyo, Japan) who underwent health checkups between 2005 and 2020. METHODS: We set the following exposures: 1) each component of the CVH metrics (body mass index, blood pressure [BP], fasting blood glucose, total cholesterol, smoking, dietary habits, and physical activity) and 2) the number of non-ideal CVH metrics (non-ideal CVH score, ranging from 0 [healthiest] to 7 [unhealthiest]). The study outcome was RVO and central RVO (CRVO) occurrence, which were identified on the first date of diagnosis. We performed Cox regression with covariates including age, sex, and glaucoma. MAIN OUTCOME MEASURES: The hazard ratios for RVO and CRVO occurrence of 1) each component of the CVH metrics and 2) the non-ideal CVH score. RESULTS: We included 2,093,536 individuals. During a mean follow-up period of 1,070 ± 884 days, there were 3,265 RVO and 789 CRVO events. Non-ideal BP was most strongly associated with an increased risk of RVO occurrence (hazard ratio [HR], 2.25 [95% confidence interval, 2.06-2.46]), followed by non-ideal body mass index (HR, 1.31 [1.21-1.41]). Individuals with non-improvement in BP within one year showed higher risk of RVO occurrence than those with improvement (HR, 2.07 [1.70-2.52]).The adjusted HRs of the groups with non-ideal CVH scores of 6-7, 5 ,4, 3, 2, and 1 were 3.76 (2.66-5.30), 2.87 (2.06-4.00), 2.57 (1.85-3.57), 2.22 (1.60-3.08), 1.79 (1.29-2.48), and 1.39 (0.99-1.95), respectively, compared with the group with a score of 0. Similar results were observed for CRVO. CONCLUSIONS: The strongest risk factor for RVO was non-ideal BP, followed by non-ideal body mass index. There was a dose-dependent positive association between the non-ideal CVH score and RVO occurrence. These findings are important with respect to the identification of individuals at higher risk of RVO.
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. Electronic address: youhashi@m.u-tokyo.ac.jp.
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