Hypertension, Cardiovascular Disease, and Age-Related Macular Degeneration

Abstract

Objectives: To describe a case-control study of risk factors for neovascular and non-neovascular age-related macular degeneration (AMD) and to present findings on associations with systemic hypertension and cardiovascular disease.Methods: Participants with and without neovascular and non-neovascular AMD were recruited from 11 ophthalmology practices in the New York, NY, metropolitan area.Comprehensive data collection included (1) a standardized interview, (2) blood pressure measurements, and (3) blood samples.Cases and controls were classified from fundus photograph gradings.Polychotomous logistic regression analyses were used to evaluate associations.Results: Classification of 1222 sets of available photographs resulted in the inclusion of a neovascular case group (n = 182), a non-neovascular case group (n = 227), and a control group (n = 235).Neovascular AMD was positively associated with diastolic blood pressure greater than 95 mm Hg (odds ratio [OR] = 4.4), self-reported use of potent antihypertensive medication (OR = 2.1), physician-reported history of hypertension (OR = 1.8), use of antihypertensive medication (OR = 2.5), combinations of self-reported and physician-reported data on hypertension and its treatment (OR = 1.7), high-density lipoprotein level (OR = 2.3), and dietary cholesterol level (OR = 2.2).Non-neovascular AMD was unrelated to hypertension or cholesterol level.No associations were found between either AMD type and other definitions of hypertension or other cardiovascular disease.Conclusions: These findings suggest that neovascular AMD is associated with moderate to severe hypertension, particularly among patients receiving antihypertensive treatment.They also support the hypotheses that neovascular and non-neovascular AMD may have a different pathogenesis and that neovascular AMD and hypertensive disease may have a similar underlying systemic process.