title: Vasodilators, blood pressure-lowering medications, and age-related macular degeneration: the Beaver Dam Eye Study.
abstract: OBJECTIVE
  To examine the association of vasodilator and antihypertensive medication use with the incidence of age-related macular degeneration (AMD).
  
  
  METHODS
  Longitudinal population-based study.
  
  
  METHODS
  Persons 43 to 86 years of age living in Beaver Dam, Wisconsin, from 1988 through 1990.
  
  
  METHODS
  Examinations were performed every 5 years over a 20-year period. There were 9676 total person-visits over the course of the study. Status of AMD was determined from grading retinal photographs.
  
  
  METHODS
  Incidence of AMD.
  
  
  RESULTS
  The 5-year incidence of early AMD over the 20-year period was 8.4%; for late AMD, it was 1.4%; for pure geographic atrophy (GA), it was 0.6%; for exudative AMD, it was 0.9%; and for progression of AMD, it was 24.9%. While adjusting for age, gender, and other factors, using a vasodilator (hazard ratio [HR], 1.72; 95% confidence interval [CI], 1.25-2.38), particularly oral nitroglycerin (HR, 1.81; 95% CI, 1.14-2.90), was associated with an increased risk of early AMD. Using an oral β-blocker was associated with an increased hazard of incident exudative AMD (HR, 1.71; 95% CI, 1.04-2.82), but not pure GA (HR, 0.51; 95% CI, 0.20-1.29) or progression of AMD (HR, 0.92; 95% CI, 0.67-1.28) over the 20-year period.
  
  
  CONCLUSIONS
  Use of vasodilators is associated with a 72% increase in the hazard of incidence of early AMD, and use of oral β-blockers is associated with a 71% increase in the hazard of incident exudative AMD. If these findings are replicated, it may have implications for care of older adults because vasodilators and oral β-blockers are drugs that are used commonly by older persons.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: kleinr@epi.ophth.wisc.edu.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Chelsea E
authors.initials: CE
authors.lastname: Myers
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D015994:Incidence; D008268:Macular Degeneration / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D012307:Risk Factors; D017678:Sex Distribution; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D014665:Vasodilator Agents