青光眼患者局部使用β受体阻滞剂与心血管和呼吸系统疾病风险之间的关联：一项回顾性队列研究。

Association between topical beta-blockers and risks of cardiovascular and respiratory disease in patients with glaucoma: a retrospective cohort study.

作者信息

Chen Hsin-Yi, Huang Wei-Cheng, Lin Cheng-Li, Kao Chia-Hung

机构信息

Department of Ophthalmology, Fu-Jen Catholic University Hospital, Fu-Jen University, New Taipei, Taiwan

School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.

出版信息

BMJ Open. 2020 Jul 22;10(7):e034361. doi: 10.1136/bmjopen-2019-034361.

DOI:10.1136/bmjopen-2019-034361

PMID:32699162

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7380834/

Abstract

OBJECTIVE

To determine if topical beta-blocker use is associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.

SETTING

A retrospective cohort analysis was conducted using the database from Taiwan's National Health Insurance programme.

PARTICIPANTS

In total, 12 336 newly diagnosed patients with glaucoma from January 2000 to December 2010 were included. The patients with glaucoma were subdivided into two cohorts according to whether they used topical beta-blockers or combination drugs (BBCDs).

PRIMARY OUTCOME MEASURES

The study endpoints included pneumonia, acute respiratory failure, stroke and coronary artery disease (CAD). Univariable and multivariable Cox proportional hazards regression models were used to estimate HRs and 95% CIs for the endpoints of both cohorts.

RESULTS

The BBCD cohort had a slightly higher risk of acute respiratory failure (adjusted HRs=1.16, 95% CI 1.00 to 1.34) and lower risk of CAD (aHR=0.93, 95% CI 0.87 to 0.99) than the non-BBCD cohort. Additionally, the risk of stroke was significantly higher in BBCD cohort than in the non-BBCD cohort (aHR=1.39, 95% CI 1.23 to 1.58), especially the ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.64; aHR=1.44, 98.75% CI 1.21 to 1.71). After considering the multiplicative interaction of age and sex, the BBCD cohort do not have higher risk of all outcomes than the non-BBCD cohort. Further time-dependent regression analysis revealed BBCD cohort had higher risk of acute respiratory failure (aHR=1.17, 95% CI 1.01 to 1.35) and ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.65) than non-BBCD cohort. However, after considering the multiplicative interaction of age and sex, the BBCD cohort had no significantly higher risk of all outcomes than the non-BBCD cohort.

CONCLUSION

Topical beta-blocker is not associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.

摘要

目的

确定局部使用β受体阻滞剂是否会增加青光眼患者患心血管疾病和呼吸系统疾病的风险。

设置

使用台湾国民健康保险计划的数据库进行回顾性队列分析。

参与者

总共纳入了2000年1月至2010年12月期间12336例新诊断的青光眼患者。根据是否使用局部β受体阻滞剂或联合药物（BBCDs），将青光眼患者分为两个队列。

主要观察指标

研究终点包括肺炎、急性呼吸衰竭、中风和冠状动脉疾病（CAD）。使用单变量和多变量Cox比例风险回归模型来估计两个队列终点的风险比（HRs）和95%置信区间（CIs）。

结果

与非BBCDs队列相比，BBCDs队列发生急性呼吸衰竭的风险略高（调整后的HRs = 1.16，95% CI 1.00至1.34），患CAD的风险较低（aHR = 0.93，95% CI 0.87至0.99）。此外，BBCDs队列中风的风险显著高于非BBCDs队列（aHR = 1.39，95% CI 1.23至1.58），尤其是缺血性中风（aHR = 1.44，95% CI = 1.26至1.64；aHR = 1.44，98.75% CI 1.21至1.71）。在考虑年龄和性别的相乘交互作用后，BBCDs队列所有结局的风险并不高于非BBCDs队列。进一步的时间依赖性回归分析显示，BBCDs队列发生急性呼吸衰竭（aHR = 1.17，95% CI 1.01至1.35）和缺血性中风（aHR = 1.44，95% CI 1.26至1.65）的风险高于非BBCDs队列。然而，在考虑年龄和性别的相乘交互作用后，BBCDs队列所有结局的风险并不显著高于非BBCDs队列。