Heart Disease Treatments That Improve Eye Health
Drugs that treat high blood pressure, high cholesterol and heart disease are currently being investigated to treat eye diseases associated with heart disease.
Blood pressure control is beneficial to decreasing the risk of eye disease. In fact, the American Diabetes Association has included in its current position statement that, Lowering blood pressure has been shown to decrease retinopathy progression in people with type 2 diabetes.
A 2019 study found that for every 20-point increase in total cholesterol, glaucoma risk increased by 7%. This same study reported that use of statins, a common class of drugs used to lower high cholesterol, lowers the risk of open-angle glaucoma. These findings suggest that controlling cholesterol levels decreases the risk of glaucoma.
Congestive Heart Failure Drugs
There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.
ACE inhibitors
Angiotensin-converting enzyme inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cant tolerate ACE inhibitors.
You may be prescribed one of the following:
voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.
ACE inhibitors shouldnt be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:
- Potassium-sparing diuretics and potassium supplements. These diuretics can cause potassium buildup in the blood, which may lead to abnormal heart rhythms. Examples include: riamterene , eplerenone , and spironolactone .
- Nonsteroidal anti-inflammatory drugs .NSAIDs such as ibuprofen, aspirin, and naproxen, can cause sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.
Beta-blockers
This may be achieved with:
Diuretics
Your doctor may recommend:
Eyes May Offer Window Into Cardiovascular Disease
Vision problems may sometimes be the only symptom a person has of a serious cardiovascular condition, a new case report suggests.
In the case, a 77-year-old man in Greece experienced three short episodes of blurred vision in his right eye. The five-minute episodes stretched over an hour in total, and after each episode, his vision returned to normal.
Concerned about this sudden problem, the man went to the eye clinic at his local hospital.
An eye exam showed that the man’s vision was good, and the pressure within his eyes was normal. But when the man’s pupils were dilated and a doctor looked more closely into his eyes, the culprit was revealed: A blood clot was blocking the blood supply in a branch of his retinal artery, which supplies blood to the lining at the back of the eye, according to the report of the man’s case.
Such clots are typically made out of cholesterol and clumps of platelets , and in the case, the clot came from the man’s carotid artery, the main artery that brings blood to the head and neck, said Dr. Ilias Georgalas, an assistant professor of ophthalmology at the National and Kapodistrian University of Athens, in Greece.
But the tiny clot was a serious health problem people with a blockage in the eye’s central or branch retinal artery have a high risk of a serious or fatal stroke, said Georgalas, who treated the man and was one of the co-authors of the case report published online today in the New England Journal of Medicine.
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What Are The Symptoms Of Congestive Heart Failure
CHF symptoms develop due to a lack of adequate blood delivery to tissues and organs of the body due to inefficient heart pumping. Symptoms can vary among individuals and differ depending on the severity of the condition and the side of the heart affected.
It is possible to have some symptoms of both left sided and right sided CHF. Early symptoms may develop slowly, and in some cases, you may not have any noticeable symptoms until CHF has progressed and become severe.
Symptoms of CHF can include:
- swelling, which may include swelling of the:
- serious or fatal cardiac arrhythmias, such as atrial fibrillation, ventricular tachycardia, or ventricular fibrillation
Defective Ocular Blood Flow
As in all vascularized tissues, a marked reduction in OBF leads to an infarction, such as retinal infarction or ischaemic anterior optic neuropathy . The main causes are arteriosclerosis and emboli or vasculitis such as giant cell arteritis. Arteriosclerosis frequently involves the retroocular vessels at early stages,9 probably due to the mechanical strain imposed by the rotating eye. In contrast, intraocular vessels may show some hyalinosis but not arteriosclerosis.
Classical ocular blood flow dysfunctions: Anterior ischaemic neuropathy. Central retinal arterial occlusion. Embolus in a retinal artery. Retinal branch vein occlusion.
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Detecting Heart Disease Through An Eye Exam
UC San Diego Health researchers see a possible way to detect heart disease through the eye
Ophthalmic optical coherence tomography scan view of the macula in retina with vessels. Getty Images
In the paper published March 2, 2021 in EClinical Medicine by The Lancet, the research team examined lesions of the retina, the inner-most, light-sensitive layer of the eye, to determine if a cardiovascular disorder may be present.
The eyes are a window into our health, and many diseases can manifest in the eye cardiovascular disease is no exception, said lead author Mathieu Bakhoum, M.D., Ph.D., a physician-scientist and retina surgeon at UC San Diego Health. Ischemia, which is decreased blood flow caused by heart disease, can lead to inadequate blood flow to the eye and may cause cells in the retina to die, leaving behind a permanent mark. We termed this mark retinal ischemic perivascular lesions, or RIPLs, and sought to determine if this finding could serve as a biomarker for cardiovascular disease.
As part of the study, the team reviewed the records of individuals who received a retinal OCT scan at UC San Diego Health from July 2014 to July 2019. From that cohort, two groups were identified after medical chart review: one consisted of 84 individuals with heart disease and the other included 76 healthy individuals as the studys control group. An increased number of RIPLs was observed in the eyes of individuals with heart disease.
No funding was reported for this research.
Is Congestive Heart Failure Curable
There are certain types of heart failure wherein the function of the heart can return to normal after appropriate medical treatment.
Heart failure is not considered cured because a person is at risk of experiencing heart dysfunction again. However, the function of the heart is essentially normal, and the outlook is excellent.
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Articles On Heart Failure Types & Stages
Congestive heart failure doesn’t mean your heart has stopped. It means it’s not pumping blood the way it should. When that happens, blood and fluid can back up in your body and make it harder for your kidneys to flush out sodium and water. That can make you hold on to too much fluid, which causes swelling.
There’s no cure. But your doctor may give you medication to do things like lower your blood pressure, relax your blood vessels, make your heart beat stronger, or ease swelling. And diet and lifestyle changes — like not smoking — can help, too.
Lifestyle Changes For Better Eye And Heart Health
These simple but effective lifestyle changes can decrease your risk of eye and heart disease:
Dont smoke or if you currently smoke, come up with a plan to stop.
Exercise for 30 to 60 minutes a day, for a total of at least 150 minutes a week.
Eat a healthy, nutritious diet high in vegetables and fruits and low in fats.
Watch your weight obesity greatly increases the risk of eye and heart disease.
Maintain good sleep habits most adults should sleep at least seven hours a night.
stress can lead to additional health problems and unhealthy coping habits.
Schedule a screening with your primary care doctor for the risk factors that cause heart and eye disease, including high blood pressure, high cholesterol and diabetes.
There is a clear link between the health of the eyes and the health of the heart. Annual comprehensive eye exams help to ensure that not only your eyes, but also your heart, stays healthy.
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How Long Can A Person Live With Congestive Heart Failure
This varies depending on the stage of the heart failure and the condition of the heart at diagnosis . For example, according to one estimate, someone who has stage C heart failure has a 75% chance of being alive 5 years later.
However, treating the heart with appropriate medical therapy is important regardless of the stage in order to improve survival as much as possible.
Heart Attack And Eye Symptoms
An eye exam could detect underlying coronary heart disease , the leading cause of heart attacks %20is,These%20deposits%20are%20called%20plaques.” rel=”nofollow”> NHS). CHD causes atherosclerosis, a build-up of plaque from cholesterol and other products, creating a blockage in the blood vessels to the heart that can lead to a heart attack. However, CHD can be associated with changes in other blood vessels around the body, including the eyes.
If your optician or ophthalmologist detects changes to the blood flow through the delicate blood vessels in the eye, it may be a very early indication that you are at increased risk of coronary heart disease.
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Congestive Heart Failure Life Expectancy
Your life expectancy after receiving a diagnosis of congestive heart failure will depend upon several factors. Among them:
The current stage of progression of your heart failure
The underlying causes of your heart failure
The degree to which other organs are involved with your heart failure
The way your body responds to treatment
Although a diagnosis of congestive heart failure will probably mean major life changes and treatment for the rest of your life, it is important to keep in mind that there are things you can do to stay healthier longer and maximize the quality of your life.
Measurement Of Ocular Blood Flow
A number of different methods are available to determine ocular blood flow , depending on the vessels of interest.7 Retroocular vessels are measured by colour Doppler imaging , while intraocular vessels can be observed directly by ophthalmoscopy or visualized with the help of fluorescence or indocyanine green angiography and BF velocity can be quantified by Laser Doppler velocimetry. The BF in a capillary bed such as the ONH can be quantified by laser-flowmetry or laser-speckling. The bulk flow to the eye can be estimated by thermography8 . The dynamic changes over time can be observed with a retinal vessel analyser .
The vessels behind the eye can be visualized and its flow quantified by colour Doppler imaging. Shown is the outcome from the ophthalmic artery of a healthy subject with normal resistivity and of a glaucoma patient with high resistivity .
The bulk flow can be quantified with the help of thermography. Left: A relatively cool eye of a subject with vascular dysregulation in relation to a normal control . The retinal circulation is visualized with fluorescence angiography and choroid circulation with the indocyanine green angiography .
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Pathophysiology Of Tissue Damage: An Ophthalmologic Perspective
Cardiologists are concerned about potential consequences of cardiovascular risk factors and whether the eye could serve as a window for morphological and functional changes preceding the changes in the heart. On the other hand, ophthalmologists are concerned about systemic conditions inducing or aggravating eye diseases. For the optimal treatment of the patients, it is of importance for the cardiologist or internist to understand the vascular pathophysiology behind the most common eye diseases. Indeed, many prevalent eye diseases can be considered systemic diseases, e.g. diabetic or hypertensive retinopathy and, to some extent, also glaucoma.
Congestive Heart Failure And Congenital Defects
The purpose of the heart is to pump blood to the body in order to nourish it. Heart failure doesn’t mean that the heart has stopped working, but that it just isn’t able to pump enough blood to meet the needs of the body.
This may occur when the heart muscle is weak or when the heart valves are leaky. When the heart does not circulate blood normally, the kidneys receive less blood and filter less fluid out of the circulation into the urine. The extra fluid in the circulation builds up in the lungs, the liver, around the eyes, and sometimes in the legs. This is called fluid “congestion” and for this reason doctors call this “congestive heart failure”.
Older children with congestive heart failure may be tired and have problems keeping up with their friends on the playground. Infants with congestive heart failure usually have symptoms during feeding including sweating, fast breathing and fatigue. These infants also may have problems gaining weight. Fluid may also build up in the rest of the body, causing swelling of the feet, the legs or around the eyes.
Medicines called diuretics , e.g., furosemide , help get rid of the extra fluid by increasing urination. To help the body rid itself of the extra fluid, a low-sodium diet may sometimes be necessary. Blood vessel relaxing medications, such as captopril or enalapril, may be used to make it easier for the heart to pump. Another medication, digoxin, may help the heart contract with more force.
Last Reviewed: Mar 22, 2022
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Mechanisms Responsible For The Functional Retinal Alterations
As shown in , a number of factors may participate in the development of the functional microvascular disarray of the retinal microvascular network that occurs in heart failure patients. A factor of primary importance is probably the endothelial dysfunction because endothelial release of nitric oxide has a powerful dilatory effect on vessels of all dimensions and a reduced ability of endothelial cells to release nitric oxide and affect vasomotor tone has been consistently reported in heart failure. Indeed, the observations made in the present study provide direct support for the involvement of the endothelial factor in the microvascular alterations of heart failure because the flicker-induced arteriolar and venular vasodilatation is specifically mediated by nitric oxide release.
Schematic drawing illustrating the potential mechanisms responsible for the retinal microcirculatory disarray in congestive heart failure. Heart failure is characterized, along with haemodynamic alterations , by insulin resistance, sympathetic overactivity, reninangiotensinaldosterone system activation, and nitric oxide impairment. All these metabolic and humoral alterations may trigger functional alterations of the retinal microvessels, by directly acting on the retinal network or, more probably, by favouring and potentiating the NO impairment at the endothelial level.
How Heart Disease Affects Eye Health
Your heart is the pump of your cardiovascular system, which includes arteries, veins and tiny blood vessels that supply blood, oxygen and nutrients to your body. Conditions that damage blood vessels, such as high blood pressure, high cholesterol and diabetes, harm the entire body, including the eyes.
The kidneys, liver and other organs vital to the maintenance of good health are also affected by risk factors like diabetes, hypertension and high cholesterol. Thus, damage in our cardiovascular system can lead to a cascade of ill health ranging from heart disease to eye disease.
A helpful framework for appreciating the way heart disease affects eye health is to understand how certain risk factors damage blood vessels leading to diabetic retinopathy, age-related macular degeneration and glaucoma.
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Yellow Bumps Around The Eyes: Xanthelasmas
Some middle-aged and older adults develop soft, yellowish, cholesterol-filled bumps on or around their eyelids, most commonly near the nose . Called xanthelasmas, these small growths arent painful and rarely affect vision. But they can be a sign of high levels of cholesterol, triglycerides, or other fats in the blood. Theyre somewhat more prevalent in women than men. People who have them should be sure to get a cholesterol test, also known as lipid test or lipid profile.
Illustration by Scott Leighton
Xanthelasmas are more common in people with genetic disorders that cause abnormally high cholesterol levels, such as familial hypercholesterolemia, which can cause LDL cholesterol levels of 190 or higher.
If your LDL is elevated, regular exercise and a high-fiber, plant-based diet can help lower it. Many people need cholesterol-lowering drugs such as statins, which will sometimes but not always reduce the size of a xanthelasma.
Half of people with xanthelasmas have normal lipid levels, and the growths are simply a cosmetic problem. But people with a family history of early heart disease should make sure their physician know about this possible sign of heightened cardiovascular risk.
Are Retinal Vessels A Window To The Heart The Cardiologist’s Perspective
The retina is a unique site where the microcirculation can be imaged directly. Thus, it provides a window for detecting changes in microvasculature relating to the development of cardiovascular diseases such as arterial hypertension or coronary heart disease10 . Analysis of the retinal microvasculature provides information about the structure as well as the function of the vessels and this information can be easily obtained repeatedly over time. However, its clinical application has only recently gained some attention.11
Examples of retinal vascular signs in patients with cardiovascular diseases. Black arrow: focal arteriolar narrowing. White arrow: arterio-venous nicking. Yellow arrow: haemorrhage. Blue arrow: micro-aneurysm. Red arrow: cotton wool spot.
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