Blood Pressure variability Associated with Macular Degeneration

 

In a recent study, researchers aimed to assess associations between long-term BPV and the risk of age-related macular degeneration (AMD) and found that a 5mm Hg increase in diastolic BPV was associated with a 54% higher risk of advanced AMD, suggesting that one of the mechanisms is choroidal ischemia and inflammation leading to choroidal thinning and ultimately to AMD onset. 

In their paper, the researchers speculated that blood pressure variability affects choroidal thickness. 

“It has been observed that, in the presence of continuous fluctuations in systemic BP, the choriocapillaris sympathetic system is overstimulated by, among others, local oxidative stress. This has been shown to induce vasoconstriction of the choriocapillaris, which can lead to ischemia and thinning of the choroid,” the authors explained in their article.

One study observed a thinning of the choroid in hypertensive patients compared to a control group, particularly in the subfoveal region. The authors also showed that the longer the duration of hypertension, the thinner the choroidal layer. Another previous study consistently reported a decrease in choroidal thickness associated with vascular risk factors.

“Choroidal ischemia and related local ‘microangiopathy’ has been put forward as one of the main mechanisms—along with inflammation—leading to choroidal thinning and ultimately to AMD onset,” they wrote.

Understanding whether long-term BPV is an independent risk factor for AMD may provide new insights for clinical and public health recommendations aimed at preserving ocular health in aging populations, the authors wrote.

“These findings underscore the need for further research to confirm this association, explore the underlying mechanisms and potential interventions that could mitigate this risk,” the researchers concluded.