Renin-Angiotensin System Inhibitors And Age-Related Macular Degeneration In Hypertensive Patients

Purpose.To assess whether renin-angiotensin system inhibitor(RASI)utilization is associated with risk of age-related macular degeneration(AMD)among hypertensive patients.Methods.A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey(NHANES)2005-2008.Hypertensive participants aged 40 years and older with gradable retinal images and ascertained RASI usage were enrolled.Diagnosis of AMD was determined through retinal image assessment using the modified Wisconsin Age-Related Maculopathy Grading System.Multivariable analyses were performed to assess the relationship between RASIs and AMD.Results.3023 out of the total 20,497 subjects of NHANES 2005-2008 were enrolled in our study.Multivariable logistic regression analyses revealed that the risk of AMD had no significant association with usage of RASIs,angiotensin converting enzyme inhibitors(ACEIs)or angiotensin receptor blockers(ARBs)(P>0.05),but was inversely correlated with RASI treatment duration(odds ratio(OR)0.87,95%confidence interval(CI)0.78-0.98).Long-term usage(>5 years)of RASIs significantly reduced not only the overall risk of AMD(OR 0.2 3,95%CI 0.14-0.38),but also that of soft drusen(OR 0.67,95%CI 0.45-0.99)and geographic atrophy(OR 0.39,95%CI 0.22-0.71).Conclusions.There is not sufficient evidence supporting the significant correlation between RASI usage and AMD in hypertensive patients.Long-term RASI treatment seemed to be beneficial for AMD,especially for drusen formation and geographic atrophy,implicating that RASIs may be prospect in AMD prevention and management.