Effect of Statins, Metformin, Angiotensin-Converting Enzyme Inhibitors, and Angiotensin II Receptor Blockers on Age-Related Macular Degeneration
10.3349/ymj.2019.60.7.679
- Author:
Hyesung LEE
1
;
Ha Lim JEON
;
Sang Jun PARK
;
Ju Young SHIN
Author Information
1. School of Pharmacy, Sungkyunkwan University, Suwon, Korea. shin.jy@skku.edu
- Publication Type:Original Article
- Keywords:
Age-related macular degeneration;
preventive effect;
cardiovascular medications
- MeSH:
Aged;
Angiotensin II;
Angiotensin Receptor Antagonists;
Angiotensin-Converting Enzyme Inhibitors;
Angiotensins;
Cardiovascular Diseases;
Case-Control Studies;
Cohort Studies;
Diabetes Mellitus;
Follow-Up Studies;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Logistic Models;
Macular Degeneration;
Metformin;
National Health Programs;
Odds Ratio;
Prescriptions;
Receptors, Angiotensin
- From:Yonsei Medical Journal
2019;60(7):679-686
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Statins, metformin, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) have been suggested for treating age-related macular degeneration (AMD) due to their pleiotropic effects. Therefore, we investigated whether these drugs prevent AMD. MATERIALS AND METHODS: We conducted a nested case-control study using the Korean National Health Insurance Service database. Using risk-set sampling of age, sex, cohort entry date, and follow-up duration, we identified incident patients with AMD and 10 matching controls in cohorts with diabetes mellitus or cardiovascular diseases. Exposure was assessed within one year before the index date using patient prescription records. We conducted conditional logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between cardiovascular medications and AMD. RESULTS: Our study included 2330 cases and 23278 controls from a cohort of 231274 patients. The ORs (95% CI) for AMD occurrence in users prescribed with statins, metformin, ACE inhibitors, and ARBs were 1.12 (0.94–1.32), 1.15 (0.91–1.45), 0.90 (0.61–1.34), and 1.21 (1.05–1.39), respectively. A duration-response was not observed. CONCLUSION: Statins, metformin, ACE inhibitors, and ARBs did not inhibit AMD in elderly patients. The absence of a duration-response supports the lack of a causal relationship.
