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S. Fraser–Bell, J. Wu, R. Klein, S.P. Azen, R. Varma, Los Angeles Latino Eye Study Group; Hypertension, Ocular Perfusion Pressure and Age–related Macular Degeneration. The Los Angeles Latino Eye Study (LALES). . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2245.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the relationship between hypertension, ocular perfusion pressure and early and advanced age related macular degeneration (AMD). Methods: The LALES is a population–based prevalence study of eye disease among Latinos aged 40 years and older. Data were collected using standardized protocols for 1) interview, 2) Blood pressure measurements, and 3) comprehensive ophthalmic examination, including measurement of intraocular pressure (IOP) by Goldmann tonometry and stereoscopic macular photographs. AMD was diagnosed from photographic grading by masked trained graders. Systolic and diastolic hypertension were defined as systolic blood pressure (SBP) >140mmHg and diastolic blood pressure (DBP) > = 85mmHg, respectively. Hypertension was defined as having a history of hypertension or measured hypertension. Ocular perfusion pressure (OPP) was defined as the difference between mean arterial blood pressure and IOP. Results: Gradable retinal photographs were available in 5875 participants. The mean age of the participants was 54.9 years and 58% were female. Hypertension was present in 2536 (43.1%) , including 1949 with uncontrolled hypertension, of which 796 were previously undiagnosed. After adjusting for age, gender, cigarette smoking and alcohol consumption, associations were found between increasing DBP (per 10mmHg) and uncontrolled diastolic hypertension (OR: 1.79, CI 1.10, 2.59, p=0.02, OR: 3.2, CI 1.1, 8.9, p=0.03, respectively) and exudative AMD. Systolic blood pressure was not related to advanced AMD. A higher OPP (per 10mmHg) was associated with a decreased risk of geographic atrophy (OR: 0.39, CI 0.28, 0.54, p<0.0001).There was no statistically significant relationship between blood pressure, hypertension, OPP and early AMD. Conclusions: These findings suggest that higher diastolic blood pressure, and diastolic hypertension are associated with exudative AMD. Systolic blood pressure was not related to advanced AMD. Higher ocular perfusion pressures appear to be protective from geographic atrophy. We found no significant associations of early AMD with blood pressure or ocular perfusion pressure. Additional longitudinal data are needed to further assess these relationships.
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