Eye :: Eye exams provide clues to heart, blood vessel health

Over a romantic candlelit dinner, the eyes may be the windows to the soul. In a more prosaic light, they’re windows to the heart, according to the March issue of the Harvard Heart Letter. A look into the eye can reveal the silent damage wrought by high blood pressure and diabetes and reflect the risk of a future stroke or heart attack.

High blood pressure and diabetes damage blood vessels throughout the body. “Changes inside the retina can offer an early warning sign of damage to the heart, kidneys, and elsewhere that may influence treatment decisions,” says Dr. John I. Loewenstein, a retina specialist at Harvard-affiliated Massachusetts Eye and Ear Infirmary, who contributed to the Harvard Heart Letter article. Such changes include narrowing or ballooning of blood vessels and swelling of the base of the optic nerve.

Four large studies have shown that people with changes in their retinal blood vessels from high blood pressure (known as hypertensive retinopathy) are two to four times as likely to have a stroke as people without such changes, reports the Harvard Heart Letter. Other studies have found that people with hypertensive retinopathy have a higher risk for heart attacks and heart failure. The link tends to be strongest in women, indicating that women may be more affected than men by damage to small blood vessels (so-called microvascular changes) from high blood pressure and diabetes.

Getting regular eye exams makes good sense, even when vision seems just fine. In addition to early detection of treatable eye problems such as glaucoma, regular eye exams also provide an opportunity for spotting subtle changes that can foreshadow the usually invisible damage from high blood pressure or diabetes, points out the Harvard Heart Letter.


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