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.