Guidelines for treatment of retinopathy do not mention heart failure, but perhaps they should, Ventura said. "Maybe the guidelines one day will say that if you have retinopathy, you should see a cardiologist," he said.
It's possible that the same kind of trouble with the eyes' microvasculature -- the tiniest blood vessels -- can also have an effect on the heart over the decades, the study authors said.
Retinopathy could be an indicator of inflammation and other damage to the endothelium, the delicate inner lining of blood vessels, Ventura said.
Dr. Nancy Sweitzer, director of the heart failure program at the University of Wisconsin, said, "The interesting thing about this study was that the association was as strong for mild degrees of eye disease as for strong degrees. It has to be taken very seriously."
While the study doesn't break new ground, she said, "no one has ever looked in such a detailed way at the association between disease in microvessels and heart failure."
Cardiologists have become more concerned about the coronary effects of diabetes in recent years, and people with diabetes should act on that concern, Sweitzer said. "They should talk to their doctor about diabetes in general, not just about retinopathy," she added.
More information
Learn more about diabetic retinopathy from the U.S. National Eye Institute.
