Chronic conditions cause a lot of wear-and-tear on the human body, especially when it comes to the eyes, according to new research. In a cross-sectional study of 387,780 individuals conducted over a span of 13 years, patients with four systemic disease types—hypertensive, respiratory conditions, heart disease and the “severely impaired”—showed an elevated risk of visual impairment.

The subjects were separated into five groups, healthy (70.5%), hypertensive (19.6%), those with respiratory conditions such as emphysema and asthma (4.4%), a heart disease group (3.6%) and the severely impaired (1.8%). Compared with the healthy group, participants in all four disease groups had elevated risk of visual impairment. Patients with a heart, respiratory or hypertensive condition were more than three times as likely to have visual impairment compared with the healthy controls; those in the severely impaired group were more than 10 times as likely.

All patients in the disease groups had an elevated risk of reporting to the emergency department, especially the severely impaired group with more than 10 times the odds of hospitalization.

The researchers hope that the characteristics of these high-risk groups identified by this study will help develop interventions to avert the more serious consequences of having multiple chronic conditions.