Association between Retinal Vein Occlusion and Life's Simple 7 Cardiovascular Health Metrics: A Large Claims Database Study

Yohei Hashimoto; Hidehiro Kaneko; Akira Okada; Hiroki Matsui; Hideo Yasunaga; Makoto Aihara; Ryo Obata

doi:10.1016/j.oret.2022.03.012

Association between Retinal Vein Occlusion and Life's Simple 7 Cardiovascular Health Metrics: A Large Claims Database Study

Ophthalmol Retina. 2022 Aug;6(8):684-692. doi: 10.1016/j.oret.2022.03.012. Epub 2022 Mar 30.

Authors

Yohei Hashimoto¹, Hidehiro Kaneko², Akira Okada³, Hiroki Matsui⁴, Hideo Yasunaga⁴, Makoto Aihara⁵, Ryo Obata⁵

Affiliations

¹ 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.
² Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴ Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
⁵ Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

PMID: 35364326
DOI: 10.1016/j.oret.2022.03.012

Abstract

Purpose: Cardiovascular diseases and retinal vein occlusion (RVO) have many risk factors in common. We aimed to investigate the associations between RVO occurrence and each of the cardiovascular health (CVH) metrics known as Life's Simple 7, which are indicators of an unhealthy lifestyle.

Design: Retrospective cohort study.

Participants: Individuals in the JMDC Claims Database (JMDC Inc) 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 nonideal CVH metrics (nonideal CVH score, ranging from 0 [healthiest] to 7 [unhealthiest]). The study outcomes were RVO and central RVO (CRVO) occurrence, which were identified on the first date of diagnosis. We performed Cox regression analyses, with covariates including age, sex, and glaucoma.

Main outcome measures: The hazard ratios for RVO and CRVO occurrence for (1) each component of the CVH metrics and (2) the nonideal CVH score.

Results: We included 2 093 536 individuals. During a mean follow-up period of 1070 ± 884 days, there were 3265 RVO and 789 CRVO events. An increased risk of RVO occurrence was most strongly associated with a nonideal BP (hazard ratio [HR], 2.25; 95% confidence interval [CI], 2.06-2.46), followed by a nonideal body mass index (HR, 1.31; 95% CI, 1.21-1.41). Individuals with nonimprovement in BP within 1 year showed a higher risk of RVO occurrence than those with improvement (HR, 2.07; 95% CI, 1.70-2.52). The adjusted HRs of the groups with nonideal CVH scores of 6 to 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 nonideal BP, followed by nonideal body mass index. There was a dose-dependent positive association between a nonideal CVH score and RVO occurrence. These findings are important with respect to the identification of individuals at higher risk of RVO.

Keywords: Cardiovascular health; Life’s Simple 7; Retinal vein occlusion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / diagnosis
Cardiovascular Diseases* / epidemiology
Humans
Quality Indicators, Health Care
Retinal Vein Occlusion* / diagnosis
Retinal Vein Occlusion* / epidemiology
Retinal Vein Occlusion* / etiology
Retrospective Studies
Risk Factors