Abstract
Objectives: :
To examine the association of age–related macular degeneration (AMD) to incident coronary heart disease (CHD) and mortality.
Methods: :
A population–based cohort study of 11,414 men and women aged 49 to 73 years sampled from four U.S. communities. Participants had retinal photographs of one eye taken between 1993 and 1995. Photographs were evaluated for the presence of early and late AMD signs according to the Wisconsin grading system. Incident CHD events (acute myocardial infarction, silent myocardial infarction, fatal CHD, and cardiac revascularization procedures) and deaths were identified prospectively using standardized methods.
Results: :
There were 555 (4.9%) individuals with AMD, of which 540 were early AMD and only 15 were late AMD cases. Over a 10–year follow–up, there were 922 incident CHD events and 833 deaths. In Poisson regression models controlling for age, gender, race, systolic blood pressure, pack years of cigarette smoking and other variables, early AMD was not associated with incident CHD (relative risk 1.10, 95% confidence intervals, 0.82 – 1.47) or all–cause mortality (relative risk 0.93, 95% confidence intervals, 0.69 – 1.26). However, participants with late AMD had a higher rate of CHD events (4 out of 15 with late AMD, compared to 918 out of 11,399 without late AMD, p=0.049, Fisher’s exact test) and all–cause mortality (4 out of 15, compared to 879 out of 11,399, p=0.043).
Conclusions: :
These data provide no evidence of an association between early AMD signs with incident CHD. Individuals with late AMD had a higher rate of CHD events and deaths than those without late AMD, but due to the small number of late AMD cases in this middle–aged cohort, this finding should be interpreted cautiously.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment • retina