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R Klein, BE K Klein, SC Tomany, KJ Cruickshanks; The Association of Blood Pressure With the 10-year Incidence of Age-related Maculopathy in the Beaver Dam Eye Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3969.
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Purpose: To examine the association of blood pressure to the10-year incidence of age-related maculopathy (ARM) in 4,926 people who were 43-86 years of age at the Beaver Dam Eye Study baseline examination in 1988-1990 of whom 3,684 persons participated at a follow-up examination in 1993-95 and 2,764 participated at follow-up in 1998-2000. Methods: Blood pressure was measured using a random-zero sphygmomanometer following the Hypertension Detection and Follow-up Program protocol. Standardized protocols were used for obtaining and reading stereoscopic color fundus photographs to measure ARM. Results: The 10-year incidence was 12.1% for early and 2.0% for late ARM. While controlling for age, sex, smoking, heavy drinking, vitamin use, and other risk factors at baseline, systolic blood pressure at baseline was associated with increased risk for the 10-year incidence of retinal pigment epithelial depigmentation (Relative Risk (RR) per 10 mmHg of systolic blood pressure: 1.09, 95% Confidence Interval (CI) 1.00, 1.17, p=.04) and exudative macular degeneration (RR 1.25, 95% CI 1.07, 1.47, p=.004). Neither systolic nor diastolic blood pressure at baseline was statistically significantly associated with the incidence of drusen ≷125 µm in diameter, soft indistinct drusen, increased retinal pigment, or geographic atrophy. While controlling for age, sex, and systolic blood pressure at baseline, increase in systolic blood pressure between baseline and the 5-year follow-up examination was associated with an increased incidence of late ARM at the 10-year follow-up. Persons in whom systolic blood pressure increased by 5 mmHg or more over the first five years of the study were 3.47 times (95% CI 1.40, 8.61, p=.01) as likely to develop signs of late ARM at the 10-year follow-up compared to persons in whom systolic blood pressure had decreased by more than 5 mmHg. Conclusion: These data show a relationship of blood pressure with the incidence of exudative macular degeneration and suggest a possible role of blood pressure in the pathogenesis of ARM.
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