title: Novel measures of cardiovascular health and its association with prevalence and progression of age-related macular degeneration: the CHARM Study.
abstract: BACKGROUND
  To determine if novel measures of cardiovascular health are associated with prevalence or progression of age-related macular degeneration (AMD).
  
  
  METHODS
  Measures of the cardiovascular system: included intima media thickness (IMT), pulse wave velocity (PWV), systemic arterial compliance (SAC), carotid augmentation index (AI). For the prevalence study, hospital-based AMD cases and population-based age- and gender-matched controls with no signs of AMD in either eye were enrolled. For the progression component, participants with early AMD were recruited from two previous studies; cases were defined as progression in one or both eyes and controls were defined as no progression in either eye.
  
  
  RESULTS
  160 cases and 160 controls were included in the prevalence component. The upper two quartiles of SAC, implying good cardiovascular health, were significantly associated with increased risk of AMD (OR = 2.54, 95% CL = 1.29, 4.99). High PWV was associated with increased prevalent AMD. Progression was observed in 82 (32.3%) of the 254 subjects recruited for the progression component. Higher AI (worse cardiovascular function) was protective for AMD progression (OR = 0.30, 95%CL = 0.13, 0.69). Higher aortic PWV was associated with increased risk of AMD progression; the highest risk was seen with the second lowest velocity (OR = 6.22, 95% CL = 2.35, 16.46).
  
  
  CONCLUSIONS
  The results were unexpected in that better cardiovascular health was associated with increased risk of prevalent AMD and progression. Inconsistent findings between the prevalence and progression components could be due to truly different disease etiologies or to spurious findings, as can occur with inherent biases in case control studies of prevalence. Further investigation of these non-invasive methods of characterizing the cardiovascular system should be undertaken as they may help to further elucidate the role of the cardiovascular system in the etiology of prevalent AMD and progression.
authors.affiliation: Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, MA, USA. mccarty.catherine@mcrf.mfldclin.edu
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McCarty
authors.forename: Adam
authors.initials: A
authors.lastname: Dowrick
authors.forename: James
authors.initials: J
authors.lastname: Cameron
authors.forename: Barry
authors.initials: B
authors.lastname: McGrath
authors.forename: Luba D
authors.initials: LD
authors.lastname: Robman
authors.forename: Peter
authors.initials: P
authors.lastname: Dimitrov
authors.forename: Gabriella
authors.initials: G
authors.lastname: Tikellis
authors.forename: Caroline
authors.initials: C
authors.lastname: Nicolas
authors.forename: John
authors.initials: J
authors.lastname: McNeil
authors.forename: Robyn
authors.initials: R
authors.lastname: Guymer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure; D002319:Cardiovascular System; D002339:Carotid Arteries / Q000502:physiology; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011674:Pulse; D018570:Risk Assessment; D012307:Risk Factors; D014666:Vasomotor System / Q000502:physiology