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The association of blood pressure and primary open-angle glaucoma: a meta-analysis.
Am J Ophthalmol 2014; 158(3):615-27.e9AJ

Abstract

PURPOSE

To conduct a systematic review and meta-analysis of the association between blood pressure levels and hypertension with primary open-angle glaucoma and intraocular pressure endpoints.

DESIGN

Systematic review with quantitative meta-analysis.

METHODS

Studies were identified by searching the PubMed and EMBASE databases. Inverse-variance weighted random-effects models were used to summarize relative risks. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity across studies.

RESULTS

Sixty observational studies were included. The pooled relative risk for primary open-angle glaucoma comparing patients with hypertension to those without hypertension was 1.16 (95% CI = 1.05-1.28), with modest heterogeneity across studies (I(2) 34.5%). Virtually all studies reported a positive association between blood pressure and intraocular pressure (IOP). The pooled average increase in IOP associated with a 10 mm Hg increase in systolic blood pressure was 0.26 mm Hg (95% CI 0.23-0.28, I(2) 30.7%), and the average increase associated with a 5 mm Hg increase in diastolic blood pressure was 0.17 mm Hg (95% CI 0.11-0.23, I(2) 90.5%).

CONCLUSIONS

In this meta-analysis, hypertension was associated with increased intraocular pressure. The association between hypertension and primary open-angle glaucoma was stronger in cross-sectional compared with case-control and longitudinal studies. Our findings support a role of increased blood pressure in elevated intraocular pressure and possibly in the development of glaucoma.

Authors+Show Affiliations

Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.Saevit Eye Hospital, Goyang, Gyeonggi-do, South Korea; Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, South Korea. Electronic address: philip.mhkim@gmail.com.Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

24879946

Citation

Zhao, Di, et al. "The Association of Blood Pressure and Primary Open-angle Glaucoma: a Meta-analysis." American Journal of Ophthalmology, vol. 158, no. 3, 2014, pp. 615-27.e9.
Zhao D, Cho J, Kim MH, et al. The association of blood pressure and primary open-angle glaucoma: a meta-analysis. Am J Ophthalmol. 2014;158(3):615-27.e9.
Zhao, D., Cho, J., Kim, M. H., & Guallar, E. (2014). The association of blood pressure and primary open-angle glaucoma: a meta-analysis. American Journal of Ophthalmology, 158(3), pp. 615-27.e9. doi:10.1016/j.ajo.2014.05.029.
Zhao D, et al. The Association of Blood Pressure and Primary Open-angle Glaucoma: a Meta-analysis. Am J Ophthalmol. 2014;158(3):615-27.e9. PubMed PMID: 24879946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association of blood pressure and primary open-angle glaucoma: a meta-analysis. AU - Zhao,Di, AU - Cho,Juhee, AU - Kim,Myung Hun, AU - Guallar,Eliseo, Y1 - 2014/05/28/ PY - 2013/12/31/received PY - 2014/05/20/revised PY - 2014/05/21/accepted PY - 2014/6/1/entrez PY - 2014/6/1/pubmed PY - 2014/11/5/medline SP - 615 EP - 27.e9 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 158 IS - 3 N2 - PURPOSE: To conduct a systematic review and meta-analysis of the association between blood pressure levels and hypertension with primary open-angle glaucoma and intraocular pressure endpoints. DESIGN: Systematic review with quantitative meta-analysis. METHODS: Studies were identified by searching the PubMed and EMBASE databases. Inverse-variance weighted random-effects models were used to summarize relative risks. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity across studies. RESULTS: Sixty observational studies were included. The pooled relative risk for primary open-angle glaucoma comparing patients with hypertension to those without hypertension was 1.16 (95% CI = 1.05-1.28), with modest heterogeneity across studies (I(2) 34.5%). Virtually all studies reported a positive association between blood pressure and intraocular pressure (IOP). The pooled average increase in IOP associated with a 10 mm Hg increase in systolic blood pressure was 0.26 mm Hg (95% CI 0.23-0.28, I(2) 30.7%), and the average increase associated with a 5 mm Hg increase in diastolic blood pressure was 0.17 mm Hg (95% CI 0.11-0.23, I(2) 90.5%). CONCLUSIONS: In this meta-analysis, hypertension was associated with increased intraocular pressure. The association between hypertension and primary open-angle glaucoma was stronger in cross-sectional compared with case-control and longitudinal studies. Our findings support a role of increased blood pressure in elevated intraocular pressure and possibly in the development of glaucoma. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/24879946/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(14)00301-8 DB - PRIME DP - Unbound Medicine ER -