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Blood Pressure Therapies May Be Causing Serious Eye Conditions

Early studies are showing that the use of vasodilators to lower BP may be related to development of early-stage age-related macular degeneration….

A long-term population-based cohort study suggests that there could be a link.

"If these findings are replicated, it may have implications for care of older adults because vasodilators and oral beta-blockers are drugs that are used commonly by older persons," the authors conclude.

Seeking to clarify the relationship between age-related macular degeneration (AMD) incidence and blood pressure lowering medications, researchers from the University of Wisconsin School of Medicine and Public Health conducted the 25-year study (1988 to 2013) of nearly 5,000 adults aged 43 to 86 in Beaver Dam, Wisconsin.

Examinations were performed every 5 years over a 20-year period for a total of 9,676 person-visits over the course of the study. AMD status was determined by grading retinal photographs.

Results indicate that use of any vasodilator such as Apresoline and Loniten, which dilate blood vessels, was associated with a 72% greater risk of developing early-stage AMD. Specifically, the authors report that an estimated 8.2% of residents not taking vasodilators developed signs of early AMD compared to 19.1% of those taking a vasodilator medication.

The study also indicates that patients taking oral beta blockers such as Tenormin and Lopressor also face a 71% increase in the risk of neovascular AMD, a more advanced and vision-threatening form of the disease. About 0.5% of participants not on beta blockers developed signs of neovascular AMD, while 1.2% of those on the drugs developed the condition.

Practice Pearls:
  • These results need to be replicated and tested in clinical trials. Further research is needed to determine the cause of these increased risks.
  • Use of any vasodilator such as Apresoline and Loniten, which dilate blood vessels, was associated with a 72% greater risk of developing early-stage AMD
  • Betablockers may also increase the risk of neovasular AMD

Published online April 2014 in Ophthalmology, the journal of the American Academy of Ophthalmology