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Incident open-angle glaucoma and blood pressure.
Arch Ophthalmol 2002; 120(7):954-9AO

Abstract

BACKGROUND

The risk of open-angle glaucoma (OAG) may be related to low blood pressure (BP) relative to intraocular pressure (IOP), ie, to low perfusion pressure (PP). Alternatively, systemic hypertension may increase OAG risk.

OBJECTIVE

To clarify these possible relationships by evaluating hypertension and PP (where PP = BP - IOP) as risk factors for incident OAG in a black population.

DESIGN

Population-based cohort study (85% participation); simple random sample of residents of Barbados, West Indies, aged 40 years and older.

PARTICIPANTS

Two thousand nine hundred eighty-nine black participants at risk; 67 developed OAG after 4 years (2.2% incidence).

MAIN OUTCOME MEASURE

Adjusted relative risk (RR) of OAG from logistic regression analyses.

RESULTS

The 4-year risk increased markedly with baseline IOP. With an IOP less than or equal to 17 mm Hg, incidence was 0.7%, increasing to 18.3% with IOP greater than 25 mm Hg, for a 25-fold increase in RR. However, OAG developed throughout the IOP range and two thirds of incident cases had baseline IOP less than 25 mm Hg. Baseline hypertension was associated with a halving of the RR of OAG (RR, 0.49; 95% confidence interval [CI], 0.29-0.85); the RR also tended to decrease as systolic BP increased (P =.07). Consistent with these findings, a lower baseline PP increased RR (systolic PP <101 mm Hg, 2.6 [95% CI, 1.3-4.9]; diastolic PP <55 mm Hg, 3.2 [95% CI, 1.6-6.6]; mean PP <42 mm Hg, 3.1 [95% CI, 1.6-6.0]).

CONCLUSIONS

As baseline IOP increased, the risk of OAG substantially increased. In contrast, persons with systemic hypertension at baseline had half the RR, suggesting that hypertension does not increase (and may decrease) the 4-year risk of OAG. Lower PP at baseline increased RR approximately 3-fold, a result consistent with the vascular hypothesis of OAG pathogenesis.

Authors+Show Affiliations

Department of Preventive Medicine, School of Medicine, University of New York at Stony Brook, L3 HSC Room 086, Stony Brook, NY 11794-8036, USA. cleske@notes.cc.sunysb.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12096967

Citation

Leske, M Cristina, et al. "Incident Open-angle Glaucoma and Blood Pressure." Archives of Ophthalmology (Chicago, Ill. : 1960), vol. 120, no. 7, 2002, pp. 954-9.
Leske MC, Wu SY, Nemesure B, et al. Incident open-angle glaucoma and blood pressure. Arch Ophthalmol. 2002;120(7):954-9.
Leske, M. C., Wu, S. Y., Nemesure, B., & Hennis, A. (2002). Incident open-angle glaucoma and blood pressure. Archives of Ophthalmology (Chicago, Ill. : 1960), 120(7), pp. 954-9.
Leske MC, et al. Incident Open-angle Glaucoma and Blood Pressure. Arch Ophthalmol. 2002;120(7):954-9. PubMed PMID: 12096967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incident open-angle glaucoma and blood pressure. AU - Leske,M Cristina, AU - Wu,Suh-Yuh, AU - Nemesure,Barbara, AU - Hennis,Anselm, PY - 2002/7/6/pubmed PY - 2002/7/23/medline PY - 2002/7/6/entrez SP - 954 EP - 9 JF - Archives of ophthalmology (Chicago, Ill. : 1960) JO - Arch. Ophthalmol. VL - 120 IS - 7 N2 - BACKGROUND: The risk of open-angle glaucoma (OAG) may be related to low blood pressure (BP) relative to intraocular pressure (IOP), ie, to low perfusion pressure (PP). Alternatively, systemic hypertension may increase OAG risk. OBJECTIVE: To clarify these possible relationships by evaluating hypertension and PP (where PP = BP - IOP) as risk factors for incident OAG in a black population. DESIGN: Population-based cohort study (85% participation); simple random sample of residents of Barbados, West Indies, aged 40 years and older. PARTICIPANTS: Two thousand nine hundred eighty-nine black participants at risk; 67 developed OAG after 4 years (2.2% incidence). MAIN OUTCOME MEASURE: Adjusted relative risk (RR) of OAG from logistic regression analyses. RESULTS: The 4-year risk increased markedly with baseline IOP. With an IOP less than or equal to 17 mm Hg, incidence was 0.7%, increasing to 18.3% with IOP greater than 25 mm Hg, for a 25-fold increase in RR. However, OAG developed throughout the IOP range and two thirds of incident cases had baseline IOP less than 25 mm Hg. Baseline hypertension was associated with a halving of the RR of OAG (RR, 0.49; 95% confidence interval [CI], 0.29-0.85); the RR also tended to decrease as systolic BP increased (P =.07). Consistent with these findings, a lower baseline PP increased RR (systolic PP <101 mm Hg, 2.6 [95% CI, 1.3-4.9]; diastolic PP <55 mm Hg, 3.2 [95% CI, 1.6-6.6]; mean PP <42 mm Hg, 3.1 [95% CI, 1.6-6.0]). CONCLUSIONS: As baseline IOP increased, the risk of OAG substantially increased. In contrast, persons with systemic hypertension at baseline had half the RR, suggesting that hypertension does not increase (and may decrease) the 4-year risk of OAG. Lower PP at baseline increased RR approximately 3-fold, a result consistent with the vascular hypothesis of OAG pathogenesis. SN - 0003-9950 UR - https://www.unboundmedicine.com/medline/citation/12096967/Incident_open_angle_glaucoma_and_blood_pressure_ L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/vol/120/pg/954 DB - PRIME DP - Unbound Medicine ER -