That Harmless Bump Near Your Eye May Be a Sign of Heart Disease

That Harmless Bump Near Your Eye May Be a Sign of Heart Disease

New, real-world study links xanthelasma to higher risk of heart attack and stroke

ORLANDO, Fla. - Xanthelasma, a yellow bump on or near your eyelid skin, has long been considered a harmless buildup of cholesterol deposits. But a new study suggests that it may also signal an increased risk of cardiovascular disease. Researchers at Massachusetts Eye and Ear analyzed a large patient record database and found that people with xanthelasma had a 14 percent risk of experiencing major cardiovascular events, such as heart attack and stroke, and a lower survival rate. The findings will be presented today at the 129^th annual meeting of the American Academy of Ophthalmology.

Researchers used the TriNetX network, a global platform of electronic health records, to compare all cardiovascular events in adults aged 18 to 90 with eyelid xanthelasma with a matched control group without xanthelasma. More than 17,000 patients were included in each group. The analysis showed:

• The xanthelasma group had a 14 percent risk of experiencing major cardiovascular events, including heart attacks or strokes, compared with 11.8 percent of controls.
• Nearly 50 percent of the xanthelasma group had high cholesterol or other lipid disorders, compared with 38 percent of controls.
• About 35 percent of the xanthelasma group had hyperlipidemia compared with 27 percent of controls.
• The xanthelasma group was more likely to undergo revascularization procedures compared with controls: percutaneous coronary intervention (0.8 percent vs. 0.5 percent) and coronary bypass (0.2 percent vs. 0.1 percent).
• The xanthelasma group used lipid-lowering medications more often than controls (32.5 percent vs. 26.8 percent).

"Even after adjusting for demographics and comorbidities, these differences remained significant, which suggests that the association is not explained solely by baseline risk factors," said lead researcher Niloufar Bineshfar, MD. "Our hope is that clinicians will view xanthelasma as a clinical clue rather than a cosmetic issue alone."

Previous studies have shown that about half of the people with xanthelasmas have high cholesterol levels, while the other half have normal cholesterol. So, some think other causes such as inflammation lead to xanthelasma.

Dr. Bineshfar said the study doesn't resolve the question of whether high cholesterol levels cause xanthelasma, but it does support the idea of referring patients with xanthelasma for a cardiovascular workup.

People develop xanthelasmas between ages 20 and 70. Most people get them between ages 35 and 55. Anyone can develop them, but it is more likely in people who:

• smoke
• are overweight
• have high levels of fat-such as cholesterol-in your blood
• have high blood pressure or diabetes
• family history of high cholesterol or xanthelasma

About the American Academy of Ophthalmology

The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart^® program provides the public with the most trusted information about eye health. For more information, visit aao.org.