Vasodilators, Blood Pressure-Lowering Medications, and Age-Related Macular Degeneration

The Beaver Dam Eye Study

      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.

      Abbreviations and Acronyms:

      AMD ( age-related macular degeneration), BDES ( Beaver Dam Eye Study), BMI ( body mass index), CI ( confidence interval), GA ( geographic atrophy), HR ( hazard ratio), IOP ( intraocular pressure), MABP ( mean arterial blood pressure), OR ( odds ratio), OPP ( ocular perfusion pressure), PP ( pulse pressure), RPE ( retinal pigment epithelial)
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      Linked Article

      • Corrigendum
        OphthalmologyVol. 123Issue 4
        • In Brief
          The authors of “Vasodilators, Blood Pressure-Lowering Medications, and Age-Related Macular Degeneration: The Beaver Dam Eye Study” (Ophthalmology 2014;121:1604-11) wish to make the following correction to their paper:
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