Cardiovascular risk factors associated with age-related macular degeneration: the Tromso Study

Purpose To examine associations between cardiovascular risk factors and age-related macular degeneration (AMD). Methods A population-based, cross-sectional study of Caucasians aged 65–87 years was conducted in Norway in 2007/2008. Retinal photographs were graded for AMD. Multivariable logistic regression analyses were performed based on questionnaires addressing habits of smoking, alcohol consumption, physical activity, health and medication; and physical examination comprising anthropometric measurements, blood pressure and blood sampling. Cardiovascular disease status was obtained from a validated end-point registry. Results Gradable photographs were available for 2631 participants, of whom 92 (3.5%) subjects had late AMD. In the multivariable analysis of late AMD, significant interactions were found between sex and the variables age, triglyceride level, use of lipid-lowering drugs and physical exercise. Current daily smoking was significantly related to late AMD in both sexes (odds ratio (OR) 4.06, 95% confidence interval (CI) 1.69–9.76 and OR 3.59, 95% CI 1.17–11.04, women and men, respectively) compared with never smokers. Higher number of pack years was associated with the presence of large drusen (>125 μm) (OR 1.04, 95% CI 1.01–1.09 per 5 years). Higher systolic blood pressure (OR 1.06, 95% CI 1.01–1.12 per 5 mmHg), overweight (OR 2.87, 95% CI 1.13–7.29) and obesity (OR 2.92, 95% CI 1.06–8.03), physical exercise duration (OR 0.41, 95% 0.18–0.96 for 30 min or more compared with less) and frequency (OR 0.46, 95% CI 0.23–0.92 for weekly or more often compared to less) were associated with late AMD in women only. Conclusions Smoking was strongly associated with AMD, in line with results from other populations. Also, late AMD was related to higher systolic blood pressure, physical inactivity, overweight and obesity in women.