PURPOSE: To determine whether blood pressure and subclinical
atherosclerosis are associated with incident age-related maculopathy
(ARM). METHODS: The study was performed within the Rotterdam Study, a
population-based, prospective cohort study in Rotterdam, The Netherlands.
A total of 4822 subjects who at baseline were aged 55 years more, were
free of ARM, and participated in at least one of two follow-up
examinations after a mean of 2 and 6.5 years, were included in the study.
At baseline, blood pressure and the presence of atherosclerosis were
determined. ARM was assessed according to the International Classification
and Grading System and defined as large, soft drusen with pigmentary
changes; indistinct drusen; or atrophic or neovascular age-related macular
degeneration. RESULTS: After a mean follow-up of 5.2 years, incident ARM
was diagnosed in 417 subjects. Increased systolic blood pressure or pulse
pressure was associated with a higher risk of ARM. Adjusted for age,
gender, smoking, total and high-density lipoprotein cholesterol, body mass
index, and diabetes mellitus, odds ratios (OR) per 10-mm Hg increase were
1.08 (95% confidence interval [CI]: 1.03-1.14) and 1.11 (95% CI:
1.04-1.18), respectively. Moreover, different measures of atherosclerosis
were associated with the risk of ARM. An increase in carotid wall
thickness (OR per 1 SD, 1.15; 95% CI: 1.03-1.28) increased the risk of
ARM. The lowest compared with the highest tertile of ankle-arm index had
an OR of 1.32 (95% CI: 1.00-1.75). A weak association was found between
aortic calcifications and the risk of ARM. CONCLUSIONS: Elevated systolic
blood or pulse pressure or the presence of atherosclerosis may increase
the risk of development of ARM
