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. 2009 Oct;116(10):1913-9.
doi: 10.1016/j.ophtha.2009.03.046. Epub 2009 Jul 9.

Age-related macular degeneration and risk of coronary heart disease and stroke: the Cardiovascular Health Study

Cong Sun  1 , Ronald Klein, Tien Y Wong
Affiliations

Age-related macular degeneration and risk of coronary heart disease and stroke: the Cardiovascular Health Study

Cong Sun et al. Ophthalmology. 2009 Oct.

Abstract

Purpose: To examine the associations of age-related macular degeneration (AMD) with incident coronary heart disease (CHD) and stroke in the Cardiovascular Health Study.

Design: Population-based prospective cohort study.

Participants: A total of 1786 white and African-American participants free of CHD or 2228 participants free of stroke, aged 69 to 97 years.

Methods: AMD was evaluated from photographs taken in 1997 and 1998.

Main outcome measures: Incident CHD and stroke ascertained using standardized methods.

Results: Of the 1786 persons free of CHD, 303 developed incident CHD over 7 years. Participants with early AMD (n = 277) had a higher cumulative incidence of CHD than participants without early AMD (25.8% vs. 18.9%, P = 0.001). By adjusting for age, gender, race, systolic and diastolic blood pressure, hypertension status, fasting glucose, triglyceride, low-density lipoprotein cholesterol, cigarette smoking, pack years of smoking, and C-reactive protein, the presence of early AMD was associated with an increased risk of incident CHD (hazard ratio 1.57; 95% confidence interval, 1.17-2.22). Late AMD (n = 25) was not associated with incident CHD (hazard ratio 0.78; 95% confidence interval, 0.25-2.48). Among 2228 persons at risk, 198 developed incident stroke; neither early nor late AMD was associated with incident stroke.

Conclusions: This study suggests persons with early AMD have a higher risk of CHD but not stroke in a population aged 69 to 97 years. This provides further support that AMD is associated with underlying systemic vascular disease.

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Figures

Figure 1
Figure 1
Coronary heart disease-free survival in participants with and without early age-related macular degeneration (AMD), adjusted for age, gender, and ethnicity. Solid line represents early AMD absent; dash line represents early AMD present.
Figure 2
Figure 2
Stroke-free survival in participants with and without early age-related macular degeneration (AMD), adjusted for age, gender, and ethnicity. Solid line represents early AMD absent; dash line represents early AMD present.
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References

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