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3 Conditions Related to AMD: Diabetes, High Blood Pressure, and Cardiovascular Disease

Medically reviewed by Angelica Balingit, M.D.
Written by Emily Wagner, M.S.
Posted on June 20, 2024

Some people with age-related macular degeneration (AMD) are more likely to have other health conditions. When you have two or more conditions at the same time, they’re known as comorbidities.

This article will discuss three conditions related to AMD. For more information on AMD or how comorbidities can affect your eye health, talk to your ophthalmologist (eye doctor).

What Is Age-Related Macular Degeneration?

AMD is an eye disease that affects the retina — the tissue found at the back of the eye. The macula is located at the center of the retina and is responsible for controlling your central vision.

Age-related macular degeneration affects the macula, the part of the retina that allows you to see what’s in front of you. (Adobe Stock)

According to the American Academy of Ophthalmology, there are two types of AMD. Dry AMD is associated with drusen (protein deposits in the retina). Wet AMD is characterized by abnormal blood vessels within the eyes that leak. Both diseases can lead to central vision loss.

If you’re living with AMD, you might have another health condition along with it. Here are three conditions related to AMD.

1. Diabetes

Diabetes mellitus is a disease caused by hyperglycemia (high blood sugar, or blood glucose). There are two main forms of diabetes mellitus — types 1 and 2.

Type 1 diabetes is an autoimmune disease that attacks the pancreas. This organ makes the hormone insulin, which cells need to use glucose for energy. Without enough insulin, glucose builds up in the blood to dangerously high levels.

Type 2 diabetes develops from a combination of genetics and lifestyle factors. In this disease, the body’s cells become resistant to insulin. This means the tissues don’t respond to the action of insulin to let glucose into cells. Lifestyle factors such as diet or lack of physical activity can contribute to type 2 diabetes.

Diabetes and Age-Related Macular Degeneration

Researchers have looked into whether having diabetes raises the risk of AMD. Some studies have found that diabetes is linked with AMD. Abnormal cholesterol levels and hyperglycemia in diabetes can lead to inflammation, which plays a role in AMD.

A meta-analysis of 27 study populations from 24 original studies, which totaled more than 1 million participants, found that diabetes is a risk factor for developing AMD. For example, a study from South Korea included 88 people with early AMD and 315 with diabetes. The authors found that people with diabetes were more likely to have AMD compared to those without the eye disease.

Diabetes may also influence the type of AMD you have. A 2023 study found that people who had diabetes for more than five years were at risk of developing wet AMD.

Other studies led to different findings. Researchers in China found that diabetes wasn’t a risk factor for AMD. However, the authors did conclude that diabetic retinopathy, a diabetes complication that can lead to vision loss, is a risk factor for dry AMD. They urged controlling diabetes to help reduce the prevalence (commonness) of AMD.

How Is Diabetes Treated?

If you have diabetes, your treatment plan will depend on the type. It’s important to keep your blood sugar levels within a healthy range, which prevents blood vessel damage in the eyes. For example, health care providers treat type 1 diabetes with insulin to supplement what the pancreas can’t make.

Type 2 diabetes is managed with medications and lifestyle changes. Your doctor will likely encourage you to take these steps:

  • Eat a healthy, low-carbohydrate diet.
  • Exercise regularly.
  • Monitor your blood sugar levels.

You’ll also want to get regular eye exams to check for any signs of AMD or diabetic retinopathy. People with diabetes are at risk of other eye problems, too, including glaucoma (a disease that damages the optic nerve).

2. High Blood Pressure

Your heart pumps blood every minute of every day, carrying oxygen and nutrients throughout your body. Blood pressure is a measurement of the amount of force your blood flow puts on your blood vessels. The higher your blood pressure, the greater your risk of health complications. This is because hypertension (high blood pressure) can damage your heart, blood vessels, and brain over time.

A healthy blood pressure measurement is anything below 120 millimeters of mercury (mm Hg) over 80 mm Hg (written as 120/80 mm Hg). Your measurements may rise over time, especially as you get older. This is because your artery walls get stiffer with atherosclerosis.

High Blood Pressure and Age-Related Macular Degeneration

High blood pressure and AMD commonly occur together. One French study followed 963 older adults with AMD. The authors found that almost half of the participants had high blood pressure.

People with high blood pressure are at risk of developing AMD or other eye problems because extra pressure can damage the retina’s delicate blood vessels. According to the Macular Society, having high blood pressure means you’re 1.5 times as likely to develop AMD compared with people who have normal blood pressure.

Research shows that high blood pressure limits blood flow to the choroid — the part of the eye that sits in front of the retina. This means the eye might not get the oxygen and nutrients it needs to function properly. Over time, limited blood flow may lead to retinal damage and AMD.

Some studies have also found that the enzyme angiotensin 2 may contribute to AMD. This enzyme plays a role in forming new, abnormal blood vessels. In wet AMD, these new blood vessels leak blood and fluid into the retina. Many blood pressure medications work by blocking the angiotensin 2 enzyme.

How Is High Blood Pressure Treated?

If you’re living with AMD, your doctor will encourage you to reach a healthy blood pressure level. They’ll likely recommend making lifestyle changes that support your heart and eye health. For example, smoking raises blood pressure, which raises your risk of AMD. Quitting smoking helps prevent your AMD from getting worse and also boosts your overall health.

Other lifestyle changes you can make to control your blood pressure levels include:

  • Getting regular exercise
  • Reaching and maintaining a healthy weight
  • Eating a healthy diet low in salt
  • Limiting how much alcohol you drink

3. Cardiovascular Disease

Cardiovascular disease describes a number of conditions that affect the heart and blood vessels. Examples include heart disease, stroke, and heart attack.

In heart disease, cholesterol and fats build up on the blood vessel walls — known as atherosclerosis. This buildup can eventually block blood flow through the vessel. A stroke occurs when a blood clot blocks a blood vessel to the brain. The brain can’t get the oxygen it needs, and cells begin to die off. During a heart attack, a blood clot blocks blood flow in part of the heart. As a result, the nearby muscle tissue dies.

Cardiovascular Disease and AMD

Cardiovascular disease and AMD share many risk factors, including smoking, inflammation, and older age. This may be why the two diseases can develop alongside each other.

In 2022, researchers made the connection that people with AMD are at risk of cardiovascular disease and stroke. Specifically, they linked drusenlike deposits underneath the retina with cardiovascular disease. In 2021, another study found that AMD may be a risk factor for developing cardiovascular disease.

How Is Heart Disease Treated?

If you’ve been diagnosed with cardiovascular disease, it’s important to work closely with your doctor. They’ll create a treatment plan to help manage your disease, which can include:

  • Getting more physical activity
  • Eating a heart-healthy diet
  • Quitting smoking
  • Taking medications to treat high cholesterol or blood pressure
  • Receiving medical procedures or surgeries

These lifestyle changes and treatments may also help support eye health.

Talk With Others Who Understand

On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, members come together to ask questions, give advice, and share their stories with those who understand.

Are you or a family member living with AMD? Do you also have other health conditions related to AMD? What steps do you take to manage them? Share your experiences in a comment below, or post a comment on your Activities page.

References
  1. Macular Degeneration — Cleveland Clinic
  2. Comorbidities — Cleveland Clinic
  3. What Is Macular Degeneration? — American Academy of Ophthalmology EyeSmart
  4. Diabetes — Cleveland Clinic
  5. Complement Activation in Obesity, Insulin Resistance, and Type 2 Diabetes Mellitus — World Journal of Diabetes
  6. Diabetes Mellitus and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis — PLOS One
  7. Diabetes Mellitus and Early Age-Related Macular Degeneration — JAMA Ophthalmology
  8. Diabetes-Related Risk Factors for Exudative Age-Related Macular Degeneration: A Nationwide Cohort Study of a Diabetic Population — Investigative Ophthalmology & Visual Science
  9. The Association Between Diabetic Retinopathy and the Prevalence of Age-Related Macular Degeneration —The Kailuan Eye Study — Frontiers in Public Health
  10. Macular Degeneration: Prevention & Risk Factors — BrightFocus Foundation
  11. Diabetes Eye Exams — MedlinePlus
  12. Blood Pressure — Cleveland Clinic
  13. Long-Term Blood Pressure and Age-Related Macular Degeneration: The Alienor Study — Investigative Ophthalmology & Visual Science
  14. High Blood Pressure and Eye Disease — Mount Sinai
  15. Age-Related Macular Degeneration — Macular Society
  16. Essential Hypertension in the Pathogenesis of Age-Related Macular Degeneration: A Review of the Current Evidence — Journal of Hypertension
  17. Smoking and High Blood Pressure — American Heart Association
  18. 10 Ways To Control High Blood Pressure Without Medication — Mayo Clinic
  19. What Is Cardiovascular Disease? — American Heart Association
  20. The Relationship Between Age-Related Macular Degeneration and Cardiovascular Disease: A Meta-Analysis — Iranian Journal of Public Health
  21. Subretinal Drusenoid Deposits Are Strongly Associated With Coexistent High-Risk Vascular Diseases — BMJ Open Ophthalmology
  22. Cardiovascular Disease — Cleveland Clinic

Posted on June 20, 2024
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Angelica Balingit, M.D. is a specialist in internal medicine, board certified since 1996. Learn more about her here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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