Cardiovascular Health Linked to Reduced Glaucoma Risk

The LE8 score's integration of modifiable health behaviors and physiological factors suggests its potential utility in glaucoma prevention and risk stratification. This recent study reinforces the overall potential utility of comprehensive cardiovascular health promotion in preventive eye care. Photo: Michael Chaglasian, OD. Click image to enlarge. Cardiovascular health is believed to play a critical role in the pathogenesis of glaucoma, and enhancing cardiovascular health may potentially lower the risk of glaucoma development. Mechanisms linked to cardiovascular diseases, such as endothelial dysfunction, oxidative stress and chronic inflammation, are also believed to contribute to the pathological development of glaucoma.Life's Essential 8 (LE8), introduced by the American Heart Association, is a comprehensive cardiovascular health assessment framework. Its eight components include four modifiable health behaviors—diet, physical activity, smoking status and sleep health—as well as four critical health factors: body mass index, blood pressure, blood glucose and blood lipid levels. This latest version included sleep health in its assessment.Researchers in China decided to evaluate glaucoma as an isolated outcome in relation to LE8 scores, rather than as part of a composite ocular disease category. They hypothesized that certain LE8 components—such as blood pressure, blood glucose, physical activity and particularly sleep health—could be strongly associated with glaucoma risk via mechanisms including vascular dysregulation, metabolic stress and circadian rhythm disruption. They found that higher LE8 scores were significantly associated with a lower risk of glaucoma. Each one-point increase in LE8 score was linked to a 2.4% reduction in glaucoma risk.This study used data from the National Health and Nutrition Examination Survey 2007 to 2008 cycle to investigate the association between LE8 scores and glaucoma risk in adults aged 40 years and older. A total of 2,446 participants were included in the final analysis, comprising 214 individuals with glaucoma and 2,232 without.Participants with high cardiovascular health (LE8 scores 80 to 100) demonstrated significantly lower odds of glaucoma compared to those with low cardiovascular health (odds ratio; OR: 0.24). After adjustment for age, gender, race, education and poverty-income ratio, the association remained significant.Among the behavioral components of LE8, the study found that both physical activity and sleep patterns significantly influenced glaucoma risk. Higher physical activity scores were associated with a reduced risk of glaucoma (OR: 1.00). Better sleep scores were independently associated with lower glaucoma risk (OR: 0.99). The researchers also found that participants with suboptimal blood pressure scores faced elevated glaucoma risk (OR: 0.99).Notably, younger participants (≤ 60 years) demonstrated a stronger protective effect from higher LE8 scores (OR: 0.96). This age-dependent variation suggests a potential differential effect of cardiovascular health on glaucoma risk.“While the findings raise the possibility that cardiovascular health may be more influential in younger adults, the cross-sectional nature of the study precludes causal inference,” the researchers wrote in their paper, which was published in International Ophthalmology.The researchers proposed that LE8 scoring may offer a useful framework for exploring systemic health in relation to glaucoma risk, particularly among younger adults. However, its application in clinical screening or prevention requires further validation in prospective studies.“LE8 assessment could improve glaucoma screening by incorporating cardiovascular health metrics and enable targeted interventions based on individual components,” they wrote. “Healthcare providers could use LE8 scores to develop personalized prevention plans that consider both traditional glaucoma risk factors and cardiovascular health status.”Click here for the journal source. Fu x, Pan X, Hu Y, et al. Association between life’s essential 8 cardiovascular health score and glaucoma risk: evidence from NHANES. Int Ophthalmol. 2025;45(1):237.