Atherosclerosis, accumulation of fatty plaques in arteries causing restricted blood flow, is responsible for most heart attacks and strokes. However, it often builds slowly and silently without symptoms before major emergency.
Therefore, researchers are looking for visible warning signs of atherosclerosis that might help doctors spot it earlier. A new study published in Atherosclerosis looks at condition called xanthelasma, where yellow patches appear around eyes. Those patches puff up when immune cells called macrophages get stuffed with cholesterol and fats. Condition is often, but not always, associated with higher cholesterol in blood too.
What Is Xanthelasma and Why Did Stanford Researchers Study It?
As fatty clumps also play role in atherosclerosis, researchers at Stanford University thought there might be link. Previous studies showed mixed results about xanthelasma and cardiovascular risk relationship.
“A few studies have supported association between xanthelasma and increased risk of cardiovascular events,” Stanford ophthalmology researcher Negin Yavari and colleagues write. “While others debate that it may not be independent risk factor once traditional risks accounted for,” they add.
As research continues to elucidate relationship between xanthelasma and cardio-cerebrovascular risk factors, team aimed to evaluate association with major cardio-cerebrovascular events, MACCEs, in large population.
The Large Study: 17,925 Patients Tracked For 10 Years
The study analyzed health data from 17,925 people diagnosed with xanthelasma and same number of matched controls. Controls had presbyopia, condition leading to farsightedness, chosen because it involved eye examination. This ensured controls did not have xanthelasma undetected. Moreover, matching helped researchers compare similar populations accurately.
Across first year, 1 percent of those with xanthelasma, 178 patients, suffered heart attack. Comparatively, only 0.35 percent, or 63, of controls suffered heart attack.
For strokes, respective figures were 0.95 percent and 0.3 percent. For transient ischemic attack, TIA or mini-stroke, it was 0.6 percent and 0.19 percent.
Those are all low percentages, but risk was several times larger for xanthelasma group consistently. Gap between two groups narrowed slightly over time, but remained substantially higher at 5 and 10 year points. “Xanthelasma is associated with higher short- and long-term incidence of MACCEs up to 10 years,” researchers write. They highlight its value as clinical marker for risk stratification and preventive management.
Analysis: Cholesterol Is Not The Only Factor Behind Risk
Incidence rates of cardiac events were similar in xanthelasma group whether or not they had abnormally high blood fat levels. This suggests high cholesterol is not only underlying factor at play.
While pale, puffy patches that characterize xanthelasma are seen as harmless themselves, findings suggest they signify something deeper. Perhaps future cardiovascular problems are already developing silently.
“Our study suggests xanthelasma can be considered as risk factor for future MACCEs,” researchers write. Most patients with xanthelasma are seen by dermatologists for cosmetic reasons initially. However, they may have undiagnosed or uncontrolled cardiovascular risk factors contributing to elevated risk. There’s no suggestion eyelid patches themselves cause heart attacks or strokes directly.
Instead, researchers suggest people with xanthelasma could be screened for early heart health problems. Xanthelasma patches are easy for doctors to spot during routine examinations. For these people, patches may serve as useful warning sign so lifestyle changes or medications start early. Early intervention could occur before MACCEs are triggered.
Future research could look in greater detail at reasons why xanthelasma patients face higher risk. Ultimately, this could give researchers better understanding of how cardiovascular problems develop.
Q&A
Q: What is xanthelasma and what does it look like?
A: Xanthelasma causes yellow, puffy patches around eyes when cholesterol-stuffed immune cells called macrophages accumulate under skin.
Q: Does xanthelasma mean you will have a heart attack?
A: No, but Stanford study found 1% of xanthelasma patients had heart attack within one year versus 0.35% controls, showing 3x higher risk.
Q: How long does xanthelasma predict heart and stroke risk?
A: Risk remained substantially higher for up to 10 years after xanthelasma diagnosis, according to Atherosclerosis journal study.
FAQ
1. Where was this xanthelasma heart risk study published?
Study was published in Atherosclerosis journal by Stanford ophthalmology researcher Negin Yavari and colleagues, analyzing 17,925 patients with xanthelasma.
2. What are MACCEs in this study?
MACCEs are major cardio-cerebrovascular events including heart attack, stroke, and transient ischemic attack or mini-stroke.
3. Is xanthelasma always caused by high cholesterol?
No, condition is often but not always associated with higher blood cholesterol; risk remained high even with normal fat levels.
4. Should I see a doctor if I have yellow patches around eyes?
Yes, researchers suggest screening for heart health problems, as patches may indicate undiagnosed cardiovascular risk factors needing early management.
5. How can doctors reduce risk after finding xanthelasma?
Researchers recommend regular monitoring, lifestyle modifications, anti-lipid therapy, and hypertension control to prevent future cardio-cerebrovascular events.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. We summarize peer-reviewed research from Atherosclerosis journal and Stanford University for educational purposes. Always consult qualified healthcare professionals, dermatologists, or cardiologists for personal evaluation of skin changes and cardiovascular risk.
