Age-related macular degeneration long has been associated with generalized atherosclerosis.
8,28 The vasculature of the eye and the heart share several common characteristics and it is plausible that risk factors for arteriosclerosis, such as diabetes and dyslipidemia also are risk factors for eye diseases.
35 Cardiovascular comorbidities were evaluated in this study, and small increased risks of AMD were found among patients with myocardial infarction, heart failure, or hyperlipidemia. The Alienor study, a smaller population-based study in France,
36 found that patients with elevated high-density lipoprotein levels were associated with approximately double the risk of AMD; however, they found no relation between systolic or diastolic blood pressure, hypertension, or use of antihypertensive medications.
37 Similarly in the current study, hypertension was not a risk factor for AMD, yet findings from a case–control study by the AREDS Research Group
17 found hypertension to be associated with a significant 1.5-fold increased risk of AMD. A recent study by Wang et al.
38 reported an independent association of coronary stenosis with early AMD, suggesting that patients with coronary heart disease could be screened for detection of early AMD. Klein et al.
39 similarly reported presence of carotid plaques and carotid artery intima-media thickness to be weakly associated with incidence of late AMD, and suggest that this may reflect reduced blood flow in choroidal blood vessels, affecting outer retinal/choroidal function. However, the investigators found no associations between angina, myocardial infarction (MI), and stroke and AMD risk. Although the increased risks of AMD among patients with cardiovascular comorbidities were small in our study, these findings could have some implications when assessing potential risks of AMD therapies. They suggest that any safety evaluation of AMD treatment should take into account patients' cardiovascular comorbidities, as well as the presence of diabetes, at the start of therapy.