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can a routine eye test predict the risk of a heart attack?

new research says that looking at the pattern of the blood vessels in your eye might predict your heart attack risk.

by dave yasvinski

jun 13 2022
read time 3 minute read
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can a routine eye test predict the risk of a heart attack?
in the future, a routine eye test may be all that is needed to determine a person’s risk of a suffering a myocardial infarction. getty
the eyes may be the windows to the soul, but a new study has found they also give a pretty good look at the heart.

the research , presented this week at the annual conference of the european society of human genetics , found that combining information about the pattern of blood vessels within the retina with a person’s genetic data may paint a better picture of heart health than established models. the discovery could allow doctors to use routine eye tests to assess the risk of coronary artery disease (cad) or myocardial infarction (mi), better known as heart attack.

“we already knew that variations in the vasculature of the retina might offer insights into our health,” said ana villaplana-velasco , a phd student at the usher and roslin institutes at the university of edinburgh in the u.k. “given that retinal imaging is a non-invasive technique, we decided to investigate the health benefits we could obtain from these images.

“first, we studied the branching patterns of the retinal vasculature by calculating a measure named fractal dimension (df) from data available from the uk biobank. we found that lower df, simplified vessel branching patterns, is related to cad and hence mi.”
by collecting and analyzing retinal images from people in the ukb — a health database of over 500,000 people — and then seeing which ones subsequently experienced a heart attack, researchers were able to create a model that accurately predicts the risk of an mi. the model incorporates df with more traditional variables, including age, sex, systolic blood pressure, bmi and smoking status, to determine the risk to an individual patient.

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“strikingly, we discovered that our model was able to better classify participants with low or high mi risk in ukb when compared with established models that only include demographic data,” villaplana-velasco said. “the improvement of our model was even higher if we added a score related to the genetic propensity of developing mi.”
“we wondered if the df-mi association was influenced by shared biology, so we looked at the genetics of df and found nine genetic regions driving retinal vascular branching patterns. four of these regions are known to be involved in cardiovascular disease genetics. in particular, we found that these common genetic regions are involved in processes related to mi severity and recovery.”
as variations in the retinal vascular pattern can reflect the presence of a range diseases (ocular and systemic), researchers may one day be able to use the model to detect other issues. the team believes every condition may present a unique retinal variation. “we would like to investigate this further, as well as undertaking a sex-specific analysis,” villaplana-velasco said.
“we know that females with a higher mi or cad risk tend to have pronounced retinal vascular deviations when compared to the male population. we would like to repeat our analysis separately in males and females to investigate if a sex-specific model for mi completes a better risk classification.”
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in the future, a routine eye test may be all that is needed to determine a person’s risk of a suffering a myocardial infarction, a massive coronary event caused by the lack of blood to the heart. heart attacks typically occur around the age of 60 and the model created by researchers achieved its best predictive performance more than five years before such an event.
“the calculation of an individualized mi risk from those over 50 years old would seem to be appropriate,” villaplan-velasco said. “this would enable doctors to suggest behaviours that could reduce risk, such as giving up smoking and maintaining normal cholesterol and blood pressure.”
 

dave yasvinski is a writer with  healthing

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