Ronald Klein1, Chelsea E Myers2, Barbara E K Klein2. 1. Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: kleinr@epi.ophth.wisc.edu. 2. Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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.
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; Stacy M Meuer; Chelsea E Myers; Gabriëlle H S Buitendijk; Elena Rochtchina; Farzana Choudhury; Paulus T V M de Jong; Roberta McKean-Cowdin; Sudha K Iyengar; Xiaoyi Gao; Kristine E Lee; Johannes R Vingerling; Paul Mitchell; Caroline C W Klaver; Jie Jin Wang; Barbara E K Klein Journal: Ophthalmic Epidemiol Date: 2014-02 Impact factor: 1.648
Authors: Redmer van Leeuwen; Sandra C Tomany; Jie Jin Wang; Ronald Klein; Paul Mitchell; Albert Hofman; Barbara E K Klein; Johannes R Vingerling; Robert G Cumming; Paulus T V M de Jong Journal: Ophthalmology Date: 2004-06 Impact factor: 12.079
Authors: Delu Song; Peiying Hua; Brian L VanderBeek; Joshua L Dunaief; Juan E Grunwald; Ebenezer Daniel; Maureen G Maguire; Daniel F Martin; Gui-Shuang Ying Journal: Retina Date: 2021-07-01 Impact factor: 3.975