Vasodilators, blood pressure-lowering medications, and age-related macular degeneration: the Beaver Dam Eye Study.

Abstract

OBJECTIVE:

To examine the association of vasodilator and antihypertensive medication use with the incidence of age-related macular degeneration (AMD).

DESIGN:

Longitudinal population-based study.

PARTICIPANTS:

Persons 43 to 86 years of age living in Beaver Dam, Wisconsin, from 1988 through 1990.

METHODS:

Examinations were performed every 5 years over a 20-year period. There were 9676 total person-visits over the course of the study. Status of AMD was determined from grading retinal photographs.

MAIN OUTCOME MEASURES:

Incidence of AMD.

RESULTS:

The 5-year incidence of early AMD over the 20-year period was 8.4%; for late AMD, it was 1.4%; for pure geographic atrophy (GA), it was 0.6%; for exudative AMD, it was 0.9%; and for progression of AMD, it was 24.9%. While adjusting for age, gender, and other factors, using a vasodilator (hazard ratio [HR], 1.72; 95% confidence interval [CI], 1.25-2.38), particularly oral nitroglycerin (HR, 1.81; 95% CI, 1.14-2.90), was associated with an increased risk of early AMD. Using an oral β-blocker was associated with an increased hazard of incident exudative AMD (HR, 1.71; 95% CI, 1.04-2.82), but not pure GA (HR, 0.51; 95% CI, 0.20-1.29) or progression of AMD (HR, 0.92; 95% CI, 0.67-1.28) over the 20-year period.

CONCLUSIONS:

Use of vasodilators is associated with a 72% increase in the hazard of incidence of early AMD, and use of oral β-blockers is associated with a 71% increase in the hazard of incident exudative AMD. If these findings are replicated, it may have implications for care of older adults because vasodilators and oral β-blockers are drugs that are used commonly by older persons.

• Authors: Ronald Klein, Chelsea E Myers, Barbara E K Klein
• Journal: Ophthalmology (Ophthalmology) Vol. 121 Issue 8 Pg. 1604-11 (Aug 2014) ISSN: 1549-4713 [Electronic] United States
• PMID: 24793737 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenergic beta-Antagonists
• Antihypertensive Agents
• Vasodilator Agents

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Hypertension (drug therapy)
• Incidence
• Macular Degeneration (diagnosis, epidemiology)
• Male
• Middle Aged
• Photography
• Risk Factors
• Sex Distribution
• Vasodilator Agents (therapeutic use)
• Wisconsin (epidemiology)