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Association between systemic arterial stiffness and age-related macular degeneration

  • Clinical Investigation
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Abstract

Background

A number of epidemiological studies suggest that age-related macular degeneration (AMD) and cardiovascular disease share the same risk factors. Systemic arterial stiffness is a clear indicator of cardiovascular disease. We investigated whether there is an association between directly measured systemic arterial stiffness and the presence of AMD.

Methods

We used a SphygmoCor 2000 system to noninvasively measure two indicators of the systemic arterial stiffness, the arterial pulse wave velocity (PWV) and the central aortic blood pressure waveform, from which the augmentation pressure is determined. We studied 50 patients with AMD (12 men, 38 women, aged 60 to 91 years, mean 77 years) and 11 age-matched control subjects (3 men, 8 women, aged 66 to 92 years, mean 75 years). All study subjects received a complete ophthalmic examination including digital fundus photography. All of the patients with AMD were classified as stage 3 or worse in at least one eye according to the AREDS system.

Results

Pulse wave velocity was significantly higher in the patients with AMD (8.2±1.1 m/s, mean ± SD) compared with controls (7.1±0.8 m/s, p=0.0025), indicating increased arterial stiffness. There was no significant difference in PWV in AMD patients with and without choroidal neovascularization. There was no association between PWV and the presence of hypertension in either the patients or the controls. The central aortic augmentation pressure was significantly higher in the AMD patients than in the controls (p=0.040), also indicating increased arterial stiffness.

Conclusions

Patients with AMD have increased systemic arterial stiffness compared with age-matched controls. Treatments aimed at preventing or reversing systemic arterial stiffness may also be effective in preventing the onset or slowing the progression of AMD.

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References

  1. Amin R, Puklin JE, Frank RN (1994) Growth factor localization in choroidal neovascular membranes of age-related macular degeneration. Invest Ophthalmol Vis Sci 35:3178–3188

    PubMed  CAS  Google Scholar 

  2. AREDS Research Group (2001) The age-related eye disease study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the age-related eye disease study report number 6. Am J Ophthalmol 132:668–681

    Article  Google Scholar 

  3. AREDS Research Group (2004) Associations of mortality with ocular disorders and an intervention of high-dose antioxidants and zinc in the age-related eye disease study. AREDS report number 13. Arch Ophthalmol 122:716–726

    Article  Google Scholar 

  4. Blacher J, Asmar R, Djane S, London GM, Safer ME (1999) Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 33:1111–1117

    PubMed  CAS  Google Scholar 

  5. Bouck N (2002) PEDF: anti-angiogenic guardian of ocular function. Trends Mol Med 8:330–334

    Article  PubMed  CAS  Google Scholar 

  6. Bramwell JC, Hill AV (1922) The velocity of the pulse wave in man. Proc R Soc Lond B Biol Sci 93:298–306

    Article  Google Scholar 

  7. Chaine G, Hullo A, Sahel J, Soubrane G, Espinasse-Berrod M, Schutz, D, Bourguignon C, Harpey C, Brault Y, Coste M, Moccatti D, Bourgeois H (1998) Case-control study of the risk factors for age related macular degeneration. Br J Ophthalmol 82:996–1002

    Article  PubMed  CAS  Google Scholar 

  8. Chirinos JA, Zambrano JP, Chakko S, Veerani A, Schob A, Willens HJ, Perez G, Mendez AJ (2005) Aortic pressure augmentation predicts adverse cardiovascular events in patients with established coronary artery disease. Hypertension 45:980–985

    Article  PubMed  CAS  Google Scholar 

  9. Chong NHV, Keonin J, Luthert PJ, Frennesson CI, Weingeist DM, Wolf RL, Mullins RF, Hageman GS (2005) Decreased thickness and integrity of the macular elastic layer of Bruch’s membrane correspond to the distribution of lesions associated with age-related macular degeneration. Am J Pathol 166:241–251

    PubMed  Google Scholar 

  10. Hall NF, Gale CR, Syddall H, Phillips DI, Martyn CN (2001) Risk of macular degeneration in users of statins: cross sectional study. BMJ 323:375–376

    Article  PubMed  CAS  Google Scholar 

  11. Hollyfield JG, Salomon RG, Crabb JW (2003) Proteomic approaches to understanding age-related macular degeneration. Adv Exp Med Biol 533:83–89

    PubMed  CAS  Google Scholar 

  12. Hussain AA, Chan WH, Marshall J (2005) Potential usefulness of AGE cross-link breakers for modulating the progression of AMD. Invest Ophthalmol Vis Sci 46:E (abstr. 1211)

    Google Scholar 

  13. Hyman L, Schachat AP, He Q, Leske MC (2000) Hypertension, cardiovascular disease, and age-related macular degeneration. Age-related macular degeneration risk factors study group. Arch Ophthalmol 118:351–358

    PubMed  CAS  Google Scholar 

  14. Imanishi R, Seto S, Toda G, Yoshida M, Ohtsuru, A, Koide Y, Baba T, Yano K (2004) High brachial-ankle pulse wave velocity is an independent predictor of the presence of coronary artery disease in men. Hypertens Res 27:71–78

    Article  PubMed  Google Scholar 

  15. Karamanoglu M, O’Rourke MF, Avolio AP, Kelly RP (1993) An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J 14:160–167

    PubMed  CAS  Google Scholar 

  16. Kass DA, Shapiro EP, Kawaguchi M, Capriotti AR, Scuteri A, deGroof RC, Lakatta EG (2001) Improved arterial compliance by a novel advanced glycation end-product crosslink breaker. Circulation 104:1464–1470

    Article  PubMed  CAS  Google Scholar 

  17. Klein R, Klein BE, Jensen SC (1997) The relation of cardiovascular disease and its risk factors to the 5-year incidence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104:1804–1812

    PubMed  CAS  Google Scholar 

  18. Klein R, Clegg L, Cooper LS, Hubbard LD, Klein BE, King WN, Folsom AR (1999) Prevalence of age-related maculopathy in the Atherosclerosis Risk in Communities Study. Arch Ophthalmol 117:203–210

    Google Scholar 

  19. Klein R, Klein BEK, Tomany SC, Cruickshanks KJ (2003) The association of cardiovascular disease with the long-term incidence of age-related maculopathy. Ophthalmology 110:636–643

    Article  PubMed  Google Scholar 

  20. Konova E, Baydanoff S, Atanasova M, Velkova A (2004) Age-related changes in the glycation of human aortic elastin. Exp Gerontol 39:249–254

    Article  PubMed  CAS  Google Scholar 

  21. Lim HE, Park CG, Shin SH, Ahn JC, Seo HS, Oh DJ (2004) Aortic pulse wave velocity as an independent marker of coronary artery disease. Blood Press 13:369–375

    Article  PubMed  Google Scholar 

  22. Lopez PF, Sippy BD, Lambert HM, Thach AB, Hinton DR (1996) Transdifferentiated retinal pigment epithelial cells are immuno-reactive for vascular endothelial growth factor in surgically excised age-related macular degeneration-related choroidal neovascular membranes. Invest Ophthalmol Vis Sci 37:855–868

    PubMed  CAS  Google Scholar 

  23. Macular Photocoagulation Study Group (1991) Argon laser photocoagualtion for neovascular maculopathy: five-year results from randomized clinical trials. Arch Ophthalmol 109:1109–1114

    Google Scholar 

  24. Martyn CN, Greenwald SE (1997) Impaired synthesis of elastin in walls of aorta and large conduit arteries during early development as an initiating event in pathogenesis of systemic hypertension. Lancet 350:953–955

    Article  PubMed  CAS  Google Scholar 

  25. Matsuoka M, Ogata N, Otsuji T, Nishimura T, Takahashi K, Matsumura M (2004) Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy. Br J Ophthalmol 88:809–815

    Article  PubMed  CAS  Google Scholar 

  26. McGwin G Jr, Owsley C, Curcio CA, Crain RJ (2003) The association between statin use and age related maculopathy. Br J Ophthalmol 87:1121–1125

    Article  PubMed  Google Scholar 

  27. McGwin G, Xie A, Owsley C (2005) The use of cholesterol-lowering medications and age-related macular degeneration. Ophthalmology 112:488–494

    Article  PubMed  Google Scholar 

  28. Morgan T, Lauri J, Bertram D, Anderson A (2004) Effect of different antihypertensive drug classes on central aortic pressure. Am J Hypertens 17:118–123

    Article  PubMed  CAS  Google Scholar 

  29. Pauca AL, O’Rourke MF, Kon ND (2001) Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 38:932–937

    Article  PubMed  CAS  Google Scholar 

  30. Sato E, Feke GT, Menke MN, McMeel JW (2005) Retinal haemodynamics in patients with age-related macular degeneration. Eye http://dx.doi.org/10.1038/sj.eye.6701951

  31. Savage MT, Ferro CJ, Pinder SJ, Tomson CR (2002) Reproducibility of derived central arterial waveforms in patients with chronic renal failure. Clin Sci (Lond) 103:59–65

    Article  Google Scholar 

  32. Smith W, Assink J, Klein R, Mitchell P, Klaver CC, Klein BE, Hofman A, Jensen S, Wang JJ, de Jong PT (2001) Risk factors for age-related macular degeneration: pooled findings from three continents. Ophthalmology 108:697–704

    Article  PubMed  CAS  Google Scholar 

  33. Snow KK, Seddon JM (1999) Do age-related macular degeneration and cardiovascular disease share common antecedents? Ophthalmic Epidemiol 6:125–143

    Article  PubMed  CAS  Google Scholar 

  34. Stitt AW (2001) Advanced glycation: an important pathological event in diabetic and age related ocular disease. Br J Ophthalmol 85:746–753

    Article  PubMed  CAS  Google Scholar 

  35. Tomany SC, Wang JJ, van Leenwen R, Klein R, Mitchell P, Vingerling JR, Klein BE, Smith W, de Jong PT (2004) Risk factors for incident age-related macular degeneration. Pooled findings from 3 continents. Ophthalmology 111:1280–1287

    Article  PubMed  Google Scholar 

  36. Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomized clinical trials—TAP Report 2. Arch Ophthalmol 119:198–207

    Google Scholar 

  37. Van Leeuwen R, Ikram MK, Vingerling JR, Witteman JC, Hofman A, de Jong PT (2003) Blood pressure, atherosclerosis, and the incidence of age-related maculopathy: the Rotterdam study. Invest Ophthalmol Vis Sci 44:3771–3777

    Article  PubMed  Google Scholar 

  38. Vasan S, Foiles P, Founds H (2003) Therapeutic potential of breakers of advanced glycation end product-protein crosslinks. Arch Biochem Biophys 419:89–96

    Article  PubMed  CAS  Google Scholar 

  39. Verbeke F, Segers P, Heireman S, Vanholder R, Verdonck P, Van Bortel LM (2005) Noninvasive assessment of local pulse pressure: importance of brachial-to-radial pressure amplification. Hypertension 46:244–248

    Article  PubMed  CAS  Google Scholar 

  40. Vingerling JR, Dielemans I, Bots ML, Hofman A, Grobbee DE, de Jong PT (1995) Age-related macular degeneration is associated with atherosclerosis. The Rotterdam study. Am J Epidemiol 142:404–409

    PubMed  CAS  Google Scholar 

  41. Waddell TK, Dart AM, Medley TL, Cameron JD, Kingwell BA (2001) Carotid pressure is a better predictor of coronary artery disease severity than brachial pressure. Hypertension 38:927–931

    Article  PubMed  CAS  Google Scholar 

  42. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, Eber B (2004) Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 109:184–189

    Article  PubMed  Google Scholar 

  43. Wilkinson IB, Cockcroft JR, Webb DJ (1998) Pulse wave analysis and arterial stiffness. J Cardiovasc Pharmacol 32:S33–S37

    PubMed  CAS  Google Scholar 

  44. Wilkinson IB, Fuchs SA, Jansen IM, Spratt JC, Murray GD, Cockcroft JR, Webb DJ (1998) Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis. J Hypertens 16:2079–2084

    Article  PubMed  CAS  Google Scholar 

  45. Wilson HL, Schwartz DM, Bhatt HRF, Mcculoch CE, Duncan JL (2004) Statin and aspirin therapy are associated with decreased rate of choroidal neovascularization among patients with age-related macular degeneration. Am J Ophthalmol 137:615–624

    Article  PubMed  CAS  Google Scholar 

  46. Zarbin MA (2004) Current concepts in the pathogenesis of age-related macular degeneration. Arch Ophthalmol 122:598–614

    Article  PubMed  Google Scholar 

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Correspondence to Gilbert T. Feke.

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Sato, E., Feke, G.T., Appelbaum, E.Y. et al. Association between systemic arterial stiffness and age-related macular degeneration. Graefe's Arch Clin Exp Ophthalmo 244, 963–971 (2006). https://doi.org/10.1007/s00417-005-0201-6

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  • DOI: https://doi.org/10.1007/s00417-005-0201-6

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