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Cited by 209Retinal Diseases and TreatmentsRetinal Imaging and AnalysisCardiovascular Health and Risk Factors

The association of cardiovascular disease with the long-term incidence of age-related maculopathy

Klein, Ronald, Klein, Barbara E.K, Tomany, Sandra C, Cruickshanks, Karen J·2003·Ophthalmology
DOI 10.1016/s0161-6420(03)00599-2
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Abstract

Purpose To examine the association between cardiovascular disease and its risk factors and the 10-year incidence of age-related maculopathy.Design Population-based cohort study.Participants Persons 43 to 86 years of age at baseline examination from 1988 to 1990, living in Beaver Dam, Wisconsin, of whom 3684 persons participated in a 5-year follow-up examination and 2764 participated in a 10-year follow-up examination.Methods Standardized protocols for physical examination, blood collection, administration of a questionnaire, and stereoscopic color fundus photography to determine age-related maculopathy. The Kaplan-Meier (product-limit) survival approach and discrete linear logistic regression were used in the data analysis.Main outcome measures Incidence and progression of age-related maculopathy.Results When age, gender, and history of heavy drinking, smoking, and vitamin use were controlled for, higher systolic blood pressure at baseline was associated with the 10-year incidence of retinal pigment epithelial depigmentation (risk ratio [RR] per 10 mmHg systolic blood pressure, 1.10; 95% confidence interval [CI], 1.01-1.18; P = 0.02) and exudative macular degeneration (RR, 1.22; 95% CI, 1.06-1.41; P = 0.006). Higher pulse pressure at baseline was associated with the incidence of retinal pigment epithelial depigmentation (RR per 10 mmHg, 1.17; 95% CI, 1.07-1.28; P < 0.001), increased retinal pigment (RR, 1.10; 95% CI, 1.01-1.19; P = 0.03), exudative macular degeneration (RR, 1.34; 95% CI, 1.14-1.60; P < 0.001), and progression of age-related maculopathy (RR, 1.08; 95% CI, 1.01-1.17; P = 0.03). Higher serum high-density lipoprotein cholesterol at baseline was associated with pure geographic atrophy (RR per 10 mg/dl high-density lipoprotein cholesterol, 1.29; 95% CI, 1.05-1.58; P = 0.01). Physical activity at baseline was associated with the incidence of geographic atrophy (RR in those who worked up a sweat 5 times a week compared with those who did not, 0.12; 95% CI, 0.02-0.91; P = 0.04) exudative macular degeneration (RR, 0.27; 95% CI, 0.08-0.87; P = 0.05), and progression of age-related maculopathy (RR, 0.69; 95% CI, 0.47-1.00; P = 0.05). Neither a history of stroke nor heart attack was associated with the incidence or progression of age-related maculopathy.Conclusions These findings indicate relationships between higher pulse pressure (a presumed indicator of age-related elastin and collagen changes in Bruch's membrane) and systolic blood pressure with an increased 10-year incidence of some lesions defining early age-related maculopathy and exudative macular degeneration.

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  • Hypertension was found to be associated with age-related macular degeneration in some studies.

    “Hypertension was found to be associated with age-related macular degeneration in some studies.87–89”

    From Age-related macular degeneration (2008) · cites this paper as [87]

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Authors
Klein, R., Klein, B. E. K., Tomany, S. C., & Cruickshanks, K. J.
Affiliations
University of Wisconsin–Madison (US)
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2003-06
Volume
110
Issue
6
Pages
1273-1280
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/s0161-6420(03)00599-2
OpenAlex
W4253427643
Cited by
209
References
49
Citations by year
2026: 4 · 2025: 11 · 2024: 11 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 7 · 2019: 4 · 2018: 12 · 2017: 11 · 2016: 11 · 2015: 4 · 2014: 13 · 2013: 6 · 2012: 13
FWCI
8.86
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
Ophthalmology (publishedVersion)
Funders
National Eye Institute (EY0-6594)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
age-related maculopathy, cardiovascular disease, systolic blood pressure, pulse pressure, HDL cholesterol, neovascular age-related macular degeneration, geographic atrophy, disease progression, risk factors, Beaver Dam Eye Study, incidence, retinal imaging, heavy drinking, smoking, vitamin use, older adults

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