高血压患者开角型青光眼发病率增加：一项为期11年的全国性回顾性队列研究。

Increased incidence of open-angle glaucoma among hypertensive patients: an 11-year nationwide retrospective cohort study.

作者信息

Rim Tyler H, Lee Sang Y, Kim Seo H, Kim Sung S, Kim Chan Y

机构信息

aDepartment of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, SeoulbDepartment of Ophthalmology, National Health Insurance Service Ilsan Hospital, GoyangcKong Eye CenterdYonsei Healthcare Big Data-Based Knowledge Integration System Research Center, Yonsei University College of MedicineeInstitute of Convergence Science, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

J Hypertens. 2017 Apr;35(4):729-736. doi: 10.1097/HJH.0000000000001225.

DOI:10.1097/HJH.0000000000001225

PMID:28253217

Abstract

OBJECTIVE

To evaluate the risk of open-angle glaucoma (OAG) among patients with systemic hypertension (HTN).

METHODS

This retrospective propensity-score-matched cohort study included patients with HTN and a matched comparison cohort from the Korean National Health Insurance Service National Sample Cohort database. The HTN group was defined as patients who were prescribed antihypertensive medication, or SBP at least 140 or DBP at least 90 mmHg. The OAG group was defined as patients satisfying OAG criteria during repeated visits to an ophthalmologist. The Charlson comorbidity index was used to control for systemic conditions. Cox proportional hazard regression analysis was performed.

RESULTS

OAG occurred in 2.0% (n = 1961) in the HTN group, and 1.7% (n = 1692) in the comparison group (P < 0.001). The OAG incidence rates in patients with and without HTN were 19.0 and 16.4 per 10 000 person-years, respectively. HTN was associated with increased OAG incidence [adjusted hazard ratio (HR) = 1.16, 95% confidence interval: 1.09-1.24] from our multivariate Cox model. Participants with higher SBP (adjusted HR = 1.12 for 120-139 mmHg group; and adjusted HR = 1.20 for ≥140 mmHg group) was more likely to have subsequent OAG compared with participants with less than 120 mmHg blood pressure. Participants with higher DBP (adjusted HR = 1.11 for 80-89 mmHg group: and adjusted HR = 1.07 for ≥90 mmHg group) showed similar trends as participants with less than 80 mmHg blood pressure.

CONCLUSION

Patients diagnosed with HTN are more likely to experience subsequent OAG than those without HTN.

摘要

目的

评估系统性高血压（HTN）患者发生开角型青光眼（OAG）的风险。

方法

这项回顾性倾向评分匹配队列研究纳入了来自韩国国民健康保险服务国家样本队列数据库的HTN患者及匹配的对照队列。HTN组定义为开具了抗高血压药物的患者，或收缩压至少140mmHg或舒张压至少90mmHg的患者。OAG组定义为在多次就诊眼科医生期间符合OAG标准的患者。采用Charlson合并症指数来控制全身状况。进行Cox比例风险回归分析。

结果

HTN组中OAG的发生率为2.0%（n = 1961），对照组为1.7%（n = 1692）（P < 0.001）。有和没有HTN的患者中OAG发病率分别为每10000人年19.0和16.4例。根据我们的多变量Cox模型，HTN与OAG发病率增加相关[调整后的风险比（HR）= 1.16，95%置信区间：1.09 - 1.24]。与血压低于120mmHg的参与者相比，收缩压较高的参与者（120 - 139mmHg组调整后的HR = 1.12；≥140mmHg组调整后的HR = 1.20）更有可能发生后续OAG。舒张压较高的参与者（80 - 89mmHg组调整后的HR = 1.11；≥90mmHg组调整后的HR = 1.07）与血压低于80mmHg的参与者表现出相似的趋势。