Among nearly 5,000 study participants, regular
aspirin use reported ten years prior was associated
with a small but statistically significant increase
in the risk of neovascular age-related macular
degeneration, according to a study in the December
19 issue of JAMA.
"Aspirin use in the United States is widespread,
with an estimated 19.3 percent of adults reporting
regular consumption, and reported use increases with
age," according to background information in the
study. "The results of cross-sectional studies of
aspirin use and its relation to age-related macular
degeneration (AMD) have been inconsistent. AMD is a
potentially blinding condition for which prevalence
and incidence are increasing with the increased
survival of the population, and regular use of
aspirin is common and becoming more widespread in
persons in the age range at highest risk for this
disease. Therefore, it is imperative to further
examine this potential association."
Barbara E. K. Klein, M.D., M.P.H., of the University
of Wisconsin School of Medicine and Public Health,
Madison, and colleagues conducted a study to examine
the association between aspirin use and AMD. The
researchers used data from the Beaver Dam Eye Study,
a longitudinal population-based study of age-related
eye diseases conducted in Wisconsin. Examinations
were performed every 5 years over a 20-year period
(1988-1990 through 2008-2010). Study participants (n
= 4,926) were 43 to 86 years of age at entry in the
study. At subsequent examinations, participants were
asked if they had regularly used aspirin at least
twice a week for more than 3 months. The average
duration of follow-up was 14.8 years.
For the study, the researchers measured the
incidences of different types of AMD (early, late,
and 2 subtypes of late AMD [neovascular AMD and pure
geographic atrophy]).
There were 512 incident cases of early AMD and 117
incident cases of late AMD over the course of the
study. The researchers found that regular use of
aspirin use 10 years prior to the retinal
examination was associated with late AMD (age- and
sex-adjusted incidence, 1.8 percent for users vs.
1.0 percent for nonusers).
When examining the relationships by late AMD subtype,
neovascular AMD was significantly associated with
such use (age-and sex-adjusted incidence, 1.4
percent for users vs. 0.6 percent for nonusers), but
not for pure geographic atrophy. Aspirin use 5 years
or 10 years prior to retinal examination was not
associated with incident early AMD.
"Our findings are consistent with a small but
statistically significant association between
regular aspirin use and incidence of neovascular AMD.
Additional replication is required to confirm our
observations. If confirmed, defining the causal
mechanisms may be important in developing methods to
block this effect to prevent or retard the
development of neovascular AMD in persons who use
aspirin, especially to prevent cardiovascular
diseases (CVD)," the authors conclude.
For more information
JAMA. 2012;308(23):2469-2478
Long-term Use of Aspirin and Age-Related Macular
Degeneration
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