Hypertensive disorders of pregnancy increase the risk of developing neovascular age-related macular degeneration in later life

ABSTRACT

Background: Hypertensive disorders of pregnancy (HDP) and short-term adverse outcomes have long been recognized; however, survivors remain at risk of long-term complications. We investigated whether HDP is associated with the development of choroidal neovascular age-related macular degeneration (CNV AMD).

Methods: We identified 31,454 women who experienced HDP based on Utah birth certificates and 62,908 unexposed women matched 2:1 to the exposed. Risk of CNV AMD was estimated using Cox models.

Findings: Women with HDP exhibited an 80% higher risk for early CNV AMD (age < 70 y; 95%CI 1.23–2.58).

Conclusion: Our findings may have implications forearlier CNV AMD screening and detection.

KEYWORDS:

• Gestational hypertension
• preeclampsia
• age-related macular degeneration
• choroidal neovascularization
• population health

Acknowledgments

Generous support for data collection, management, extraction, and analysis was provided by the Steele Center for Translational Medicine (GSH), the University of Utah Department of Ophthalmology and Visual Sciences, an unrestricted grant from Research to Prevent Blindness, Inc. and the John A. Moran Presidential Professorship (GSH). Research reuse of Utah Medicare claims data (originally obtained by KRS) was authorized by the Centers for Medicare & Medicaid (CMS) in Data Use Agreement 25883, “Genetic and Molecular Studies Of Eye Diseases” (GSH). We express our appreciation to Dr. Heidi Hanson for her invaluable assistance in extracting data from Medicare beneficiary claims. Partial support for data collection and analysis within the Utah Population Database (UPDB) was provided by the Huntsman Cancer Foundation, University of Utah, and Huntsman Cancer Institute Cancer Center Support grant, P30 CA2014 from the National Institutes of Health (NIH)/National Cancer Institute. The University of Utah’s Program in Personalized Health and Center for Clinical and Translational Science supported in part the design and conduct of the study. Support for the collection, use, and management of Medicare files linked to the UPDB was provided by NIH/National Institute on Aging R01 AG022095 Early Life Conditions, Survival, and Health: A Pedigree-Based Population Study (KRS). We thank the Utah State Department of Health for additional support for sharing of statewide health data. MWV is supported by an NIH/National Center for Advancing Translational Sciences award 1UL1TR001067 and by the HA and Edna Benning Presidential Endowment.

Disclosure statement

Dr. Gregory S. Hageman is a shareholder and co-founder of Voyant Biotherapeutics, LLC. The other authors have no potential conflict of interest to report.

Summary statement

Do women with a history of hypertensive disorders of pregnancy have a higher incidence of neovascular age-related macular degeneration (AMD) later in life? In a population-based study of 94,362 women, those who experienced hypertensive disorders of pregnancy (HDP) were 80% more likely to develop early-onset choroidal neovascularization AMD.

Supplementary materials

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Additional information

Funding

This work was supported by the National Institute on Aging [R01 AG022095];Research to Prevent Blindness [N/A];John A. Moran Eye Center and the Steele Center for Translational Medicine [N/A];National Cancer Institute [P30-CA2014];National Center for Advancing Translational Sciences [1UL1TR001067].