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At the heart of general practice since 1960

Retinopathy without diabetes still a major CHD risk factor

By Nigel Praities

GPs should evaluate and manage the coronary risk of patients with retinopathy, regardless of diabetes status, say researchers.

In the first study to make this comparison, they found retinopathy in patients without diabetes increased the risk of death from coronary heart disease by as much as the presence of diabetes alone.

The Australian study in nearly 3,000 patients showed CHD mortality with diabetes alone was 14.8% compared with retinopathy alone, which was 16.8%. Patients with both diabetes and retinopathy had the highest CHD risk, at 19.3%.

Retinopathy was an independent predictor of CHD death in people with and without diabetes, with increasing severity also associated with a greater risk of CHD mortality.

The researchers concluded the presence of retinopathy, regardless of a person's diabetes status, may indicate underlying subclinical vascular disease and encouraged better screening and management of these patients.

‘Our findings support a role for direct opthalmoscopy to help identify people who may be at risk of CHD events.

'Such people may benefit from a thorough cardiovascular risk assessment, lifestyle changes and better management of risk factors and closer monitoring for CHD events,' the researchers said.

The paper is published early online in the journal Heart.

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