Analysis of data on 1,828 subjects from the Framingham Heart and Eye Studies shows a small and consistent significant association between age-related maculopathy and systemic hypertension. The association was found using blood pressure and medical history data collected both 25 years before the eye examination and concurrently with the eye examination. Prevalence of age-related maculopathy progressively increases with increasing duration of systemic hypertension. Previous epidemiologic studies of the association between systemic blood pressure and age-related maculopathy have produced conflicting results. The failure of some studies to detect an association may have resulted from inadequate sample sizes to detect the small relative risks and problems in determining the duration of the systemic hypertension.