Klein R, Klein B E, Jensen S C
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA.
Ophthalmology. 1997 Nov;104(11):1804-12. doi: 10.1016/s0161-6420(97)30023-2.
The purpose of the study is to examine the association between cardiovascular disease and its risk factors and the incidence of age-related maculopathy.
A population of 3583 adults (range, 43-86 years of age at baseline) living in Beaver Dam, Wisconsin, was studied at baseline and 5 years later.
Standardized protocols for physical examination, blood collection, administration of a questionnaire, and stereoscopic color fundus photography to determine age-related maculopathy were used. Standard univariate and multivariate analyses were performed.
Incidence and progression of age-related maculopathy were measured.
After controlling for age and gender, the authors found both higher systolic blood pressure (odds ratio [OR] per 10 mmHg, 1.16; 95% confidence interval [CI] 1.05, 1.27) and uncontrolled treated hypertension (OR 1.98, 95% CI 1.00, 3.94) were related to the incidence of retinal pigment epithelial depigmentation. After controlling for age and gender, the authors found that both blood pressure and uncontrolled treated hypertension were not significantly associated with an increased risk of having exudative macular degeneration develop (for systolic blood pressure, OR 1.18, 95% CI 0.95, 1.45; for uncontrolled treated hypertension, OR 2.10, 95% CI 0.54, 8.11). After controlling for age and gender, the authors found higher pulse pressure was significantly associated with increased incidence of retinal pigment epithelial depigmentation (OR per 10 mmHg 1.27, 95% CI 1.14, 1.42) and exudative macular degeneration (OR per 10 mmHg 1.29, 95% CI 1.02, 1.65). These relations remained significant after controlling for other risk factors in multivariable analyses.
These findings indicate modest relations between higher pulse pressure (a presumed indicator of atherosclerotic vascular disease) and uncontrolled hypertension with increased 5-year incidence of retinal pigment epithelial depigmentation. Overall, however, data from this study show neither consistent nor strong relations between cardiovascular disease and most of its risk factors with the incidence of lesions associated with age-related maculopathy.
本研究旨在探讨心血管疾病及其危险因素与年龄相关性黄斑病变发病率之间的关联。
对居住在威斯康星州比弗代尔的3583名成年人（基线年龄范围为43 - 86岁）进行了基线研究，并在5年后再次研究。
采用标准化方案进行体格检查、血液采集、问卷调查以及立体彩色眼底照相，以确定年龄相关性黄斑病变。进行了标准的单变量和多变量分析。
测量年龄相关性黄斑病变的发病率和进展情况。
在控制年龄和性别后，作者发现收缩压升高（每10 mmHg的比值比[OR]为1.16；95%置信区间[CI]为1.05, 1.27）以及未控制的高血压治疗（OR为1.98，95% CI为1.00, 3.94）均与视网膜色素上皮脱色素的发病率相关。在控制年龄和性别后，作者发现血压和未控制的高血压治疗与渗出性黄斑变性发生风险增加均无显著关联（收缩压方面，OR为1.18，95% CI为0.95, 1.45；未控制的高血压治疗方面，OR为2.10，95% CI为0.54, 8.11）。在控制年龄和性别后，作者发现脉压升高与视网膜色素上皮脱色素的发病率增加（每10 mmHg的OR为1.27，95% CI为1.14, 1.42）以及渗出性黄斑变性（每10 mmHg的OR为1.29，95% CI为1.02, 1.65）显著相关。在多变量分析中控制其他危险因素后，这些关系仍然显著。
这些发现表明较高脉压（动脉粥样硬化性血管疾病的一个假定指标）和未控制的高血压与视网膜色素上皮脱色素5年发病率增加之间存在适度关联。然而，总体而言，本研究数据显示心血管疾病及其大多数危险因素与年龄相关性黄斑病变相关病变的发病率之间既无一致关系也无强关联。
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