Cardiovascular Risk Factors and Age-related Macular Degeneration: The Los Angeles Latino Eye Study

Abstract

To assess the association of cardiovascular risk factors and ocular perfusion pressure with early and advanced age-related macular degeneration (AMD) in Latinos. Population-based, cross-sectional study. Data were collected from a population-based sample of self-identified adult Latinos using standardized protocols for assessing blood pressure and intraocular pressure (IOP) measurement and stereoscopic macular photography. Hypertension was defined as either a history of hypertension or systolic blood pressure (SBP) > 140 mm Hg +/- diastolic blood pressure (DBP) > or = 85 mm Hg. Ocular perfusion pressure (OPP) was defined as the difference between mean arterial blood pressure and IOP. AMD was diagnosed from photographic grading by masked trained graders. Logistic regression was used to assess associations. Gradable retinal photographs were available in 5,875 participants. After adjusting for age, gender, and cigarette smoking, higher DBP and uncontrolled diastolic hypertension were associated with exudative AMD (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.8; and OR, 3.3; CI, 1.2 to 9.3, respectively). Higher OPP was associated with a decreased risk of geographic atrophy (GA) (OR, 0.4 per 10 mm Hg; CI, 0.3 to 0.5). Low pulse pressure was associated with a lower risk of exudative AMD (OR, 0.2; CI, 0.1 to 0.6). Obesity was associated with increased retinal pigment (OR, 1.6; CI, 1.0 to 2.3). These data suggest that in Latinos cardiovascular risk factors may play a role in advanced AMD. Given that Latinos have a high prevalence of cardiovascular risk factors, an intervention aimed at reducing these risk factors may also have a beneficial impact on the risk of having early and advanced AMD.