New data have linked regular aspirin use to neovascular age-related macular degeneration, a leading cause of blindness in older people. This association appears to be independent of a history of CVD and smoking, researchers reported in a study in JAMA Internal Medicine.
Aspirin is one of the most widely used medications in the world, with many patients using it for primary prevention of CVD and secondary prevention of recurrent CVD, including MI and ischemic stroke, researchers wrote.
Researcher Gerald Liew, PhD, of the University of Sydney in Australia, and colleagues examined data during a 15-year period (1992-1994 to 2007-2009) on 2,389 participants aged at least 49 years, 257 (10.8%) of whom engaged in regular aspirin use, which was defined as once or more per week in the past year. Of these, 63 participants developed neovascular age-related macular degeneration.
“The cumulative incidence of neovascular [age-related macular degeneration] among regular 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 and 9.3% at 15 years, respectively,” the investigators wrote. “Regular aspirin use was significantly associated with an increased incidence of neovascular [age-related macular degeneration].”
The research indicates that, after adjustment for multiple variables, regular aspirin users had an increased risk for developing neovascular age-related macular degeneration (OR=2.46; 95% CI, 1.325-4.83). Researchers also found a dose-response relationship (multivariate-adjusted P=.01 for trend). Data did not associate aspirin use with incidence of geographic atrophy (multivariate-adjusted OR=0.99; 95% CI, 0.59-1.65).
Based on the outcomes of their research, Liew and colleagues suggest there is insufficient evidence to recommend changing clinical practice. “Except perhaps in patients with strong risk factors for neovascular [age-related macular degeneration] (eg, existing late [age-related macular degeneration] in the fellow eye), in whom it may be appropriate to raise the potentially small risk of incident neovascular [age-related macular degeneration] with long-term aspirin therapy,” they wrote.
In an invited commentary in JAMA Internal Medicine, Sanjay Kaul, MD, and George A. Diamond, MD, both of Cedars-Sinai Medical Center in Los Angeles, wrote: “The principal finding is that regular aspirin use is associated with an approximately 2.5-fold greater risk of incident age-related [age-related macular degeneration]. In the final analysis, decisions about aspirin use are best made by balancing the risks against the benefits in the context of each individual’s medical history and value judgment.”
For more information:
Kaul S. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.2530.
Liew G. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.1583.
Disclosure: The researchers report no relevant financial disclosures. Kaul and Diamond report no relevant financial disclosures.