1. Age-related macular degeneration was significantly associated with heart failure (HF), with odds of HF varying by comorbidity.
Evidence Rating Level: 2 (Good)
Due to the high mortality and morbidity associated with heart failure (HF), increased efforts have recently been put forth to better understand its risk factors. Microvasculature is one particular area in which there may be promise in predicting and preventing HF. Age-related macular degeneration (AMD) in the context of HF has been largely unexplored, though AMD manifests through development of neovascularization or geographic atrophy. This population-based cohort study sought to investigate this association. Using the Taiwan National Health Insurance Research Database, a nested case-control study of adults over 50 years of age was conducted with newly diagnosed HF cases (N=13,721) and controls (N=54,884) matched by age, sex, polypharmacy, and comorbidities (M [SD] age = 63.15 [8.1] years, 49.02% female). All participants had at least two clinical visits and a diagnosis of AMD a minimum of one year prior to HF diagnosis. This study found that AMD was associated with a significantly increased risk of HF (OR = 1.58, 95% CI 1.16 to 1.87, p<.001) after adjusting for age, sex, propensity score, and number of outpatient visits. Odds of HF varied by comorbidity: diabetes mellitus (OR = 1.56, 95% CI 1.18 to 1.84, p<.001), hypertension (OR = 1.48, 95% CI 1.12 to 1.68, p<.001), and coronary artery disease (OR = 1.28, 95% CI 1.08 to 1.53, p = .002). Among those without these comorbidities, no significant associations between HF and AMD were observed. Overall, this study found a significant association between HF and AMD, suggesting a need for future studies on the pathophysiology that may underly this relation.
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