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Link Between Regular Aspirin Use and Age-Related Macular Degeneration

Incidence of AMD more than double in aspirin users vs. nonusers (Jan. 21)

Regular aspirin use appears to be associated with an increased risk of neovascular age-related macular degeneration (AMD), which is a leading cause of blindness in older people, and it appears to be independent of a history of cardiovascular disease and smoking, according to a report published online in JAMA Internal Medicine.

Aspirin is one of the most widely used medications in the world and is commonly used in the prevention of cardiovascular disease, such as myocardial infarction and ischemic stroke. While a recent study suggested that regular aspirin use was associated with AMD — particularly the more visually devastating neovascular (wet) form — other studies have reported inconsistent findings. Smoking is also a preventable risk factor for AMD, the authors say.

To determine whether regular aspirin use (defined as once or more per week in the past year) was associated with a higher risk of developing AMD, researchers analyzed data from an Australian study that included four examinations during a 15-year period. Of the 2,389 participants, 257 (10.8%) were regular aspirin users.

After the 15-year follow-up, 63 of the 257 regular aspirin users (24.5%) developed incident neovascular AMD, according to the authors.

“The cumulative incidence of neovascular AMD among nonregular aspirin users was 0.8% at 5 years, 1.6% at 10 years, and 3.7% at 15 years; among regular aspirin users, the cumulative incidence was 1.9% at 5 years, 7.0% at 10 years, and 9.3% at 15 years, respectively,” the authors note. “Regular aspirin use was significantly associated with an increased incidence of neovascular AMD.”

The authors state that any decision concerning whether to stop aspirin therapy is “complex and needs to be individualized.”

“Currently, there is insufficient evidence to recommend changing clinical practice, except perhaps in patients with strong risk factors for neovascular AMD (e.g., existing late AMD in the fellow eye) in whom it may be appropriate to raise the potentially small risk of incident neovascular AMD with long-term aspirin therapy,” the authors conclude.

Source: JAMA Internal Medicine; January 21, 2013.

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