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The association of blood pressure and primary open-angle glaucoma: a meta-analysis.

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.

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  • Publisher Full Text
  • 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.

    Source

    American journal of ophthalmology 158:3 2014 Sep pg 615-27.e9

    MeSH

    Blood Pressure
    Glaucoma, Open-Angle
    Global Health
    Humans
    Hypertension
    Incidence
    Intraocular Pressure
    Risk Factors

    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 -