Associations of Age-Related Maculopathy With Blood Pressure: The Alienor Study

Abstract

Purpose: : Blood pressure has been suggested to be implicated in the etiology of age-related maculopathy (ARM). However, epidemiological data are scarce and contradictory in this field. The strength of the present study is that there was a long-term assessment of blood pressure status.

Methods: : The Alienor Study is a population-based epidemiological study on nutrition and age-related eye diseases. 963 subjects had an eye examination from September 2006 to May 2008 in Bordeaux (France). Of these, 879 subjects (91 %) had gradable photographs and were classified in 5 exclusive stages (worse eye): neovascular ARM (stage 4, n= 25); geographic atrophy (stage 3, n=24); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (stage 2, n=92); large soft distinct drusen alone or pigment abnormalities alone (stage 1, n=158); stage 0 (n=580). Blood pressure measured at four occasions over the 7 years preceding the eye examination. The average of blood pressure over the 7-year period was calculated. Potential confounders were age, gender, socio-economic status, monthly income, body mass index, plasma HDL-cholesterol, Complement Factor H Y402H and apolipoprotein E2 and E4 polymorphisms. Of 879 subjects, 789 had complete data for blood pressure and potential confounders. Associations were estimated using polytomous logistic regression, after adjustment for age and gender.

Results: : After adjustment for all potential confounders, high average systolic blood pressure was associated with increased risk for ARM (pooled stages 1 to 4) (OR=1.10 for 10 mmHg increase, 95 % confidence interval (CI): 1.00-1.21, p=0.05), while no significant association were found with diastolic blood pressure (OR=1.09, 95% CI: 0.90-1.32, p=0.36). Associations of systolic BP with the different stages of ARM were similar (OR ranging from 1.03 to 1.26), although they did not individually reach statistical significance.

Conclusions: : This study confirms a modest association of ARM with higher systolic blood pressure in the 7 years preceding the eye examination.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment