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Middle-aged and older adults with trouble seeing, hearing or both may face a higher risk of having a stroke or heart attack than those with good eyesight and hearing, according to a new study in China.

The , published Tuesday in the Journal of the 91ÊÓƵ, suggest screening for sensory deficits, treating them with eyeglasses or hearing aids, and focusing on this group's cardiovascular health could help reduce such risks.

The analysis likely resonates in the United States, where heart disease remains the No. 1 cause of death, with stroke at No. 5, and an aging population faces more hearing and vision loss.

An estimated 13% of children and adults in the U.S. are , while about 15% of adults have at least some even when using a hearing aid, according to data from the Centers for Disease Control and Prevention. But research shows that by the time people reach age 71, more than one-quarter are visually impaired, and 55% of those 75 and older have disabling hearing loss.

In the new study, researchers examined survey data for 11,332 participants from China who were age 45 and older without a history of cardiovascular disease. They had provided information about their hearing and vision in 2011. After seven years of follow-up, 2,156 participants said they'd been diagnosed with a stroke, cardiac arrest, heart attack, chest pains, severe arrhythmias, heart failure or other cardiovascular problems.

Compared with participants who had not reported any sensory issues, those with only vision problems were 24% more likely to develop cardiovascular disease, and those with only hearing loss were 20% more likely. Participants with both hearing and vision problems had a 35% increased risk of cardiovascular disease.

While previous studies have shown a connection between cardiovascular disease and people with hearing loss, vision problems or a combination of both, the researchers said their study was different in that it compared all three scenarios. It also focused specifically on cardiovascular disease, whereas previous research has explored the effects of sensory loss on quality of life, cognitive function and death rates.

"With the continuous aging of the population, the incidence and prevalence of hearing loss and impaired vision are increasing," said the study's senior author, Dr. Xiaowei Zheng, of the Public Health Research Center and department of public health and preventive medicine at Jiangnan University Wuxi School of Medicine in China.

Globally, by 2050, an estimated 895 million people will have impaired vision, according to a report by the . The 2.5 billion people will have hearing loss by that same year.

"We look forward to future research to assess the effect of wearing glasses or hearing aids on the development" of cardiovascular disease, Zheng said.

Researchers aren't certain why adults with hearing and vision problems face higher cardiovascular risks. A published in Preventing Chronic Disease found that 3 in 5 adults in the U.S. with vision loss had multiple risk factors, particularly high blood pressure and obesity, perhaps because they found it more difficult to be physically active. Meanwhile, hearing loss can affect communication and cognitive abilities in older people, the authors of the new study wrote. That might lead to mental health conditions, such as anxiety or depression, that make people less social and active – both risk factors for cardiovascular disease.

Dr. Rebecca Boxer, division chief of geriatrics at UC Davis Health in Sacramento, California, said she welcomed any additional attention to the broader health effects of sensory impairment. So far, much of the research has focused on the link between hearing loss, cognitive impairment and dementia.

"Sensory deficits in general, in a lot of diseases, have not been the focus of research," said Boxer, who was not involved in the new study. "From the geriatrics perspective, sensory deficits impact everything for people. It affects their quality of life and the ability to do things they enjoy."

However, she cautioned that the new research showed only an association between sensory loss and cardiovascular disease, not that one caused the other. More research is needed to see whether a lack of physical activity is to blame or if other factors are at play, she said. For example, Boxer would be interested to know if the survey respondents who developed cardiovascular disease regularly took their medications for any underlying diseases, such as diabetes.

Boxer also noted that studies based on self-reporting, such as in a survey, aren't as reliable as hard, verifiable data. For example, she said, people often deny having hearing problems when a hearing test would show otherwise.

Better understanding the connection between hearing, vision and cardiovascular disease is important, Boxer said. "We really need to study this in a more rigorous way."