title: Long-term blood pressure and age-related macular degeneration: the ALIENOR study.
abstract: OBJECTIVE
  To explore the association of AMD with long-term average blood pressure (BP) parameters, including pulse pressure (PP).
  
  
  METHODS
  The ALIENOR study is a population-based study on age-related eye diseases in 963 residents of Bordeaux, France, aged 73 years or older. AMD was graded from nonmydriatic color retinal photographs, in three exclusive stages: no AMD (1015 eyes), large soft distinct drusen and/or large soft indistinct drusen and/or reticular drusen and/or pigmentary abnormalities (early AMD, 276 eyes), and late AMD (66 eyes). BP parameters were measured at four occasions over a 7-year period. PP was defined as systolic BP minus diastolic BP. Associations of AMD with BP parameters were estimated using generalized estimating equation logistic regressions. Statistical analyses included 702 subjects (1357 eyes) with complete data.
  
  
  RESULTS
  After adjustment for age, sex, educational level, smoking, body mass index, plasma HDL and LDL cholesterol, CFH Y402H, ApoE2, ApoE4, and ARMS2 A69S polymorphisms, elevated PP was significantly associated with an increased risk of late AMD (odds ratio [OR] = 1.37 for a 10-mm Hg increase, 95% confidence interval [CI]: 1.03-1.82). Associations were similar for late atrophic and late neovascular AMD (OR = 1.39, 95% CI: 1.01-1.92, P = 0.04, and OR = 1.43, 95% CI: 0.90-2.23, P = 0.13, respectively). Association with early AMD was in the same direction but did not reach statistical significance (OR = 1.12, 95% CI: 0.98-1.28). Early and late AMD were not significantly associated with systolic or diastolic BP, hypertension, or use of antihypertensive medications.
  
  
  CONCLUSIONS
  This study suggests that high PP may be associated with increased risk for AMD.
authors: Université Bordeaux, Bordeaux, France.
authors: Audrey
authors: A
authors: Cougnard-Grégoire
authors: Marie-Noëlle
authors: MN
authors: Delyfer
authors: Jean-François
authors: JF
authors: Korobelnik
authors: Marie-Bénédicte
authors: MB
authors: Rougier
authors: Florence
authors: F
authors: Malet
authors: Mélanie
authors: M
authors: Le Goff
authors: Jean-François
authors: JF
authors: Dartigues
authors: Joseph
authors: J
authors: Colin
authors: Pascale
authors: P
authors: Barberger-Gateau
authors: Cécile
authors: C
authors: Delcourt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005602:France; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D008268:Macular Degeneration / Q000503:physiopathology*; D008297:Male; D011674:Pulse; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents