American Journal of Epidemiology Vol. 128, No. 2: 402-409
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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DIABETIC RETINOPATHY AND CARDIOVASCULAR DISEASE IN TYPE II DIABETICS
THE FRAMINGHAM HEART STUDY AND THE FRAMINGHAM EYE STUDY
1Biometry and Epidemiology Program, National Eye Institute National Institutes of Health, Bethesda, MD
2Framingham Heart Study, National Heart, Lung, and Blood Institute Framingham, MA
Reprint requests to Rita Hiller, Biometry and Epidemiology Program, National Eye Institute, National Institutes of Health, Building 31, Room 6A16, Bethesda, MD 20892
Data from the Framingham Heart Study and the Framingham Eye Study were used to examine the association between diabetic retinopathy and the occurrence of cardiovascular events (coronary heart disease, intermittent claudication, congestive heart failure, and stroke). Among the 206 persons with Type II diabetes in the Framingham Eye Study, the odds ratios for diabetic retinopathy and cardiovascular disease were 14.3 (95% confidence interval (Cl) = 2.7–101.9), 2.0 (95% Cl = 0.5–8.1), and 0.3 (95% Cl = 0.05–1.3) for ages 52–64, 65–74, and 75–85 years, respectively. The test for homogeneity indicated highly significant differences for the odds ratios across age groups. The associations were similar when sex, duration of diabetes, age at diagnosis of diabetes, and history of insulin treatment were accounted for by logistic regression. Our data suggest an association in younger diabetics between diabetic retinopathy, a small vessel complication of diabetes, and a group of cardiovascular events commonly thought to result from large vessel disease. The finding may merely indicate that diabetics with large vessel disease are also more likely to have small vessel disease. However, it is also consistent with the hypothesis, suggested by histologic data, that a more generalized microangiopathy affecting not only the eye but also organs such as the heart may play a role in the pathogenesis of cardiovascular disease in diabetics.
age factors; cardiovascular diseases; coronary disease; diabetes mellitus; diabetic retinopathy
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