Age-Related Macular Degeneration and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

Abstract

Objective To determine whether age-related macular degeneration (AMD) is a risk indicator for coronary heart disease (CHD) and cardiovascular disease (CVD) events independent of other known risk factors in a multi-ethnic cohort. Design Population-based prospective cohort study. Participants A diverse population sample of 6233 men and women aged 45–84 without known CVD from the Multi-Ethnic Study of Atherosclerosis (MESA). Methods Participants in the MESA had retinal photographs taken between 2002 and 2003. Photographs were evaluated for AMD. Incident CHD/CVD events were ascertained during clinical follow-up visits for up to 8 years after the retinal images were taken. Main Outcome Measures Incident CHD/CVD events. Results Of the 6814 persons at risk of CHD, there were 893 participants with early AMD (13.1%) and 27 (0.5%) at baseline. Over a mean follow-up period of 5.4 years, there was no statistically significant difference in incident CHD or CVD between the AMD and non-AMD groups (5.0%vs. 3.9%, p=0.13 for CHD and 6.6 vs. 5.5%, p=0.19 for CVD, respectively). In Cox regression models adjusting for CVD risk factors, there was no significant relationship between presence of any AMD and any CHD/CVD events (HR=0.99, 95% CI 0.74–1.33, p=0.97). No significant association was found between subgroups of early AMD or late AMD and incident CHD/CVD events. Conclusions In persons without a history of cardiovascular disease, AMD was not associated with an increased risk of CHD or CVD.

Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors

“…However, in the Cardiovascular Health Study [122] comprised of a cohort of white Americans and African Americans, early AMD but not late AMD was associated with an increased risk of CHD. The baseline presence of AMD did not predict occurrence of CHD or CVD in the Multi-Ethnic Study of Atherosclerosis (MESA, [123]) full population, but late AMD did associate with both CVD and CHD in a subgroup comprised of older (65+) white participants. In a meta-analysis published in 2014 of eight prospective and five retrospective studies, Wu et al [124] reported that patients with early AMD had an increased risk for CVD and for CHD.…”

Associations of Alzheimer rsquo s disease with macular degeneration

“…Stroke risk has been found to be associated with AMD in a court of patients from (52). However, an association between AMD and Coronary atherosclerotic heart disease (CHD) or Classical cardiovascular disease (CVD), in people without known risk factors of CVD, has failed to be found (53). Moreover, a novel study performed a meta-regression analysis seeking for an association with incident stroke but no association has been found (54).…”

Age-related macular degeneration and protective effect of HMG Co-A reductase inhibitors (statins): results from the National Health and Nutrition Examination Survey 2005–2008

“…[1][2][3][4] AMD becomes clinically evident typically after 50 years of age, 5 and is classified based upon disease severity. 6 Early AMD is characterized by the presence of drusen and pigmentary abnormalities in the retinal pigment epithelium (RPE) and late AMD is characterized by degenerative changes in the RPE, Bruch's membrane, and choriocapillaris, resulting in geographic atrophy and/or neovascular AMD.…”

“…10 The disease is related to well-known risk factors, such as cigarette smoking, elevated serum cholesterol levels, and hypertension, that are shared with atherosclerosis and consequently with increased risk of cardiovascular disease (CVD). 1,6,11 Genetic studies have reported similar susceptibility genes for CVD and AMD, such as complement factor H loci. 9,12,13 Therefore, a modification in atherosclerotic changes with lipid-lowering medications may exert a preventive effect in AMD development by prevention of lipid deposits at the level of Bruch's membrane.…”