Systemic hypertension and glaucoma: mechanisms in common and co-occurrence

Langman, M. J. S.; Lancashire, R. J.; Cheng, K. K.; Stewart, P. M.
August 2005
British Journal of Ophthalmology;Aug2005, Vol. 89 Issue 8, p960
Academic Journal
Aims: To determine whether systemic hypertension and glaucoma might coexist more often than expected, with possible implications for treatment. Methods: Case-control study using general practitioner database of patients with glaucoma matched with controls for age and sex. Results: Hypertension was significantly more common in the 27 080 patients with glaucoma (odds ratio 1.29, 95% confidence intervals 1.23 to 1.36, p<0.001) than in controls. Treatment by oral β blockade appeared to protect from risk (odds ratio 0.77, 95% Cl 0.73 to 0.83, p<0.0001), but oral calcium channel antagonists or angiotensin converting enzyme (ACE) inhibitors did not (odds ratios 1.34, 1.24 to 1.44 and 1.16 1.09-1.24, respectively, p<0.0001 in each case). Oral corticosteroid treatment was associated., with enhanced risk (odds ratio 1.78, 1.61 to 1.96). Conclusion: Common pathogenetic mechanisms in ciliary and renal tubular epithelia may explain coincidence of glaucoma and systemic hypertension. The choice of cardiovascular treatment, could substantially influence glaucoma incidence, with β blockade protecting and ACE inhibitors or calcium channel blockers not affecting underlying risk.


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