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全身性抗高血压药物与原发性开角型青光眼的发病

Systemic antihypertensive medication and incident open-angle glaucoma.

作者信息

Müskens Rogier P H M, de Voogd Simone, Wolfs Roger C W, Witteman Jacqueline C M, Hofman Albert, de Jong Paulus T V M, Stricker Bruno H C, Jansonius Nomdo M

机构信息

Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

出版信息

Ophthalmology. 2007 Dec;114(12):2221-6. doi: 10.1016/j.ophtha.2007.03.047. Epub 2007 Jun 12.

Abstract

PURPOSE

To determine the association between systemic antihypertensive medication and incident open-angle glaucoma.

DESIGN

Prospective population-based cohort study.

PARTICIPANTS

The study population consisted of a subset of 3842 participants of the Rotterdam Study for whom data from identical ophthalmologic examinations at baseline and follow-up were available.

METHODS

Use of antihypertensive medication was registered over an average follow-up period of 6.5 years. Associations between incident open-angle glaucoma and antihypertensive medication were assessed using multivariate logistic regression models adjusted for age, gender, duration of follow-up, intraocular pressure, intraocular pressure-lowering medication, and cardiovascular disease.

MAIN OUTCOME MEASURES

Odds ratios of associations between incident open-angle glaucoma and use of antihypertensive medication.

RESULTS

During follow-up, there were 87 incident cases of open-angle glaucoma. Participants using calcium channel antagonists had a 1.8-fold (95% confidence interval [CI], 1.04-3.2; P = 0.037) higher risk of developing incident open-angle glaucoma. beta-Blockers were associated with a nonsignificant risk reduction (odds ratio, 0.6; 95% CI, 0.3-1.02; P = 0.060). None of the other classes of antihypertensives was significantly associated with incident open-angle glaucoma.

CONCLUSIONS

These data suggest that use of calcium channel antagonists is associated with open-angle glaucoma, but this requires confirmation. These results do not support the use of calcium channel antagonists for the treatment of normal-tension glaucoma.

摘要

目的

确定全身性抗高血压药物与原发性开角型青光眼发病之间的关联。

设计

基于人群的前瞻性队列研究。

参与者

研究人群包括鹿特丹研究中3842名参与者的一个子集,这些参与者在基线和随访时均有相同的眼科检查数据。

方法

在平均6.5年的随访期内记录抗高血压药物的使用情况。使用多变量逻辑回归模型评估原发性开角型青光眼与抗高血压药物之间的关联,并对年龄、性别、随访时间、眼压、降眼压药物和心血管疾病进行校正。

主要观察指标

原发性开角型青光眼与抗高血压药物使用之间关联的比值比。

结果

随访期间,有87例原发性开角型青光眼发病病例。使用钙通道拮抗剂的参与者发生原发性开角型青光眼的风险高1.8倍(95%置信区间[CI],1.04 - 3.2;P = 0.037)。β受体阻滞剂与风险降低无显著关联(比值比,0.6;95%CI,0.3 - 1.02;P = 0.060)。其他类别的抗高血压药物均与原发性开角型青光眼无显著关联。

结论

这些数据表明使用钙通道拮抗剂与原发性开角型青光眼有关,但这需要进一步证实。这些结果不支持使用钙通道拮抗剂治疗正常眼压性青光眼。

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