THURSDAY, Jan. 5 (HealthDay News) -- Daily aspirin use among
seniors may double their risk of developing a particularly advanced
form of age-related macular degeneration, a debilitating eye
disease, a large new European study suggests.
The possible link involves the so-called "wet" type of
age-related macular degeneration (AMD), a significant cause of
blindness in seniors.
Aspirin use was not, however, found to be associated with an
increased risk for developing the more common, and usually less
advanced, "dry" form of AMD, according to the report published in
the January issue of
Although the study team stressed that further research is
needed, the findings could cause concern for the millions of older
people who routinely take over-the-counter aspirin for pain,
inflammation and blood-clot management, and to reduce their risk of
"People should be aware that aspirin, often just bought over the counter without prescription, may have adverse effects -- apart from major gastrointestinal and other bleeding -- also for AMD," said lead author Dr. Paulus de Jong.
De Jong is an emeritus professor of ophthalmic epidemiology at
the Netherlands Institute for Neuroscience of the Royal Academy of
Arts and Sciences, as well as the Academic Medical Center, both in
Age-related macular degeneration affects the critical central
vision required for reading, driving and general mobility. The
damage occurs when the retinal core of the eye (the macula) becomes
exposed to leaking or bleeding due to abnormal growth of blood
To examine whether aspirin use might trigger this process, the
authors focused on nearly 4,700 men and women over age 65 living in
Norway, Estonia, the United Kingdom, France, Italy, Greece and
In the study, conducted between 2000 and 2003, the researchers
looked at blood samples, frequency of aspirin use (though not
doses), smoking and drinking history, stroke and heart attack
records, blood pressure levels and sociodemographic data.
The team also analyzed detailed images of each participant's
eyes, looking for indications of age-related macular degeneration
Daily aspirin use was associated with the onset of late-stage
"wet" age-related macular degeneration, and to a lesser degree, the
onset of early "dry" AMD -- even after the researchers took into
account age and a history of heart disease, which in itself is a
risk factor for AMD.
For late-stage wet AMD only, the association was stronger the
more frequently an individual took aspirin.
Early AMD was found in more than more than one-third of
participants (36 percent), while late-stage AMD was found in
roughly 3 percent, or 157 patients.
Of those with late AMD, more than two-thirds (108) had wet AMD,
while about one-third (49) had dry AMD, the researchers found.
More than 17 percent of participants said they took aspirin
daily, while 7 percent took it at least once a week and 41 percent
did so at least once a month.
About one-third of those with wet AMD consumed aspirin on a
daily basis, compared with 16 percent of those with no AMD.
The study authors cautioned that further research is needed on
aspirin's possible effects on eye health. Meanwhile, they suggested
that doctors generally should not alter their current advice for
aspirin use among older patients coping with heart disease
"[But] I would advise persons who [already] have early or late AMD not to take aspirin as a painkiller," de Jong said. "[And] I would advise people with AMD who take small amounts of aspirin for primary prevention -- this means having no past history of cardiac or vascular problems like stroke, and no elevated risk factors for these diseases -- to discuss with their doctor if it is wise to continue doing so. For secondary prevention -- this means after having these elevated risks or disorders -- the benefits of daily aspirin outweigh the risks."
While the study uncovered an association between aspirin use and
AMD, it did not prove a cause-and-effect relationship.
This point was also made by Dr. Alfred Sommer, a professor of
ophthalmology and dean emeritus at the Bloomberg School of Public
Health at Johns Hopkins University in Baltimore. He noted that
while the study was "well executed," it should not be seen as
definitive proof that aspirin use and AMD are linked.
An observational study of this type "merely calls attention to
the fact that such an association may exist, and that it may be
causal, but only randomized clinical trials can prove the matter
one way or the other," he said.
"Hence, this might or might not be real," Sommer added, "and we will only know that when and if a randomized trial is done."
In the interim, he said the findings should not guide patient
"It is well known that aspirin [and other NSAIDs] can increase the risk of gastric distress and gastric ulcers," Sommer said. "Like any medicine, it should only be taken if needed. But those taking aspirin to prevent heart disease, particularly those at increased risk of heart disease, definitely do benefit and should not change what they do."
For more on age-related macular degeneration, visit the
U.S. National Eye Institute.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.