Yes, People with Comorbidities Have Higher Risk of Macular Degeneration
People with cardiovascular disease, diabetes, and related metabolic comorbidities demonstrate consistently elevated risk for developing age-related macular degeneration (AMD), with the strongest associations seen for diabetes, stroke, and dyslipidemia.
Cardiovascular Comorbidities and AMD Risk
The relationship between cardiovascular disease and AMD is well-established across multiple large-scale studies:
History of stroke increases AMD risk approximately 2-fold (RR 2.01,95% CI 1.12-3.58), with any cardiovascular disease history (stroke, myocardial infarction, or angina) conferring a 57% increased risk of incident early AMD 1.
Myocardial infarction, heart failure, and hyperlipidemia all show positive associations with AMD development, though the effect sizes are modest 2.
The prevalence of cardiovascular diseases is consistently higher among AMD patients compared to age-matched controls 2.
Diabetes and AMD
Diabetes shows particularly strong associations with specific AMD subtypes:
Diabetes predicts geographic atrophy with nearly 4-fold increased risk (RR 3.89,95% CI 1.36-11.08), though the association with neovascular AMD is less clear 1.
Use of antidiabetic medications correlates with increased AMD risk, suggesting the diabetic disease process itself contributes to AMD pathogenesis 2.
Lipid Abnormalities
Dyslipidemia demonstrates important relationships with AMD progression:
Elevated total/HDL cholesterol ratio predicts late AMD (RR per SD increase 1.35,95% CI 1.07-1.70) and geographic atrophy specifically (RR per SD 1.63,95% CI 1.18-2.25) 1.
Higher HDL cholesterol appears protective, with each standard deviation increase associated with 26% reduced risk of late AMD (RR 0.74,95% CI 0.56-0.99) 1.
Hyperlipidemia shows moderate and consistent associations with AMD across multiple cohort studies 3.
Other Cardiovascular Risk Factors
Hypertension and higher plasma fibrinogen demonstrate moderate associations with AMD, though blood pressure measurements alone (systolic, diastolic, or pulse pressure) do not consistently predict AMD development 1, 3.
Higher body mass index shows moderate association with AMD risk 3.
Shared Pathophysiologic Mechanisms
The convergence of cardiovascular and AMD risk factors suggests common causal pathways:
Age, smoking, hypertension, hypercholesterolemia, and dietary factors affect both conditions similarly 4.
This overlap raises the possibility that atherosclerotic and inflammatory processes contributing to cardiovascular disease may also drive AMD pathogenesis 4.
Clinical Implications
Healthcare utilization patterns reflect this comorbidity burden, as AMD patients demonstrate higher frequency of primary care visits and specialist referrals compared to controls, independent of their eye disease 2.
The strength of these associations varies, with diabetes and stroke showing the most robust evidence, while hypertension and general cardiovascular disease show more modest but consistent effects across multiple high-quality prospective studies 2, 1, 3.