Age-Related Macular Degeneration and Coronary Artery Disease in a VA Population

Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. Although AMD shares multiple risk factors with coronary artery disease (CAD), the association between AMD and CAD has not been established. The objective of our study was to demonstrate an association between the diagnosis of AMD and CAD and/or major cardiovascular risk factors.

We performed a retrospective chart review of >13,000 patients at the Lexington Veterans Affairs Medical Center. Patients diagnosed as having AMD served as cases, and patients diagnosed with cataract and no AMD served as controls. We examined the prevalence of CAD and associated risk factors in both groups using univariate analysis followed by multivariate analyses to examine the association between AMD and CAD after adjusting for known common risk factors.

We identified 3950 patients with AMD and 9166 controls. Patients with AMD were on average 6 years older than controls (P < 0.001) and had a significantly higher prevalence of CAD (39% vs 34%) and hypertension (88% vs 83%) but lower incidence of diabetes mellitus and smoking. Estimated odds ratio relating CAD to AMD was 1.22 (95% confidence interval 1.13-1.32; P < 0.001). The association between CAD and AMD remained significant in multivariate analyses in older individuals (76 years and older). When we conducted a secondary analysis and matched the AMD and non-AMD groups based on age, the association between CAD and AMD remained significant (39.4% in the AMD group vs 36.6% in the non-AMD group; P = 0.011).

These findings support the existence of an association between CAD and AMD, particularly in older adult patients in the predominantly male Veterans Affairs population. Such an association between AMD and systemic vascular disease justifies the potential coscreening for these conditions.