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抗高血压药物的使用与青光眼发病风险:来自 45 岁及以上研究的结果。

Use of antihypertensive medications and the risk of glaucoma onset: Findings from the 45 and Up Study.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Clin Exp Ophthalmol. 2022 Aug;50(6):598-607. doi: 10.1111/ceo.14107. Epub 2022 May 31.

Abstract

BACKGROUND

Abnormal blood pressure is a potential risk factor for glaucoma. However, the role of antihypertensive medications on glaucoma pathogenesis is controversial. This study aims to investigate the association between the use of antihypertensive medications and glaucoma onset.

METHODS

This nested case-control study, based on a large-scale longitudinal cohort in Australia, retrieved participants' claims records on drugs and Medicare services from national health databases. Participants with three or more claim records of anti-glaucoma medications from 2009 to 2016 were classified as glaucoma patients; those with none were classified as controls. Claim records of antihypertensive medications were identified within the 5 years before glaucoma onset and contemporary periods in matched controls without glaucoma. The association between the use of antihypertensive medications and glaucoma onset was assessed by multivariable logistic regression models.

RESULTS

A total of 6748 cases and 13 496 controls were analysed. Compared with controls, the proportion of users of antihypertensive medications was slightly higher in glaucoma patients (46.9% vs. 46.0%, p > 0.05). After adjustments for demographics, health-related factors and medical history, the association between the use of antihypertensive medications and glaucoma onset was nonsignificant (OR 0.95, 95% CI = 0.89-1.02). As for specific subtypes, only beta-blocking agents (BBA) (OR 0.82, 95% CI = 0.75-0.90) and diuretics (OR 0.85, 95% CI = 0.77-0.95) were significantly associated with reduced risks of glaucoma onset.

CONCLUSIONS

This study indicated that the use of antihypertensive medications was not associated with glaucoma onset. Decreased risks of glaucoma onset in users of BBA and diuretics require further validation.

摘要

背景

血压异常是青光眼的潜在风险因素。然而,降压药物在青光眼发病机制中的作用存在争议。本研究旨在探讨降压药物的使用与青光眼发病之间的关系。

方法

本巢式病例对照研究基于澳大利亚一项大规模纵向队列,从国家健康数据库中检索参与者的药物和医疗保险服务索赔记录。2009 年至 2016 年间有三次或以上抗青光眼药物索赔记录的参与者被归类为青光眼患者;没有青光眼的参与者被归类为对照组。在青光眼发病前 5 年和同期无青光眼的匹配对照者中,确定了降压药物的索赔记录。使用多变量逻辑回归模型评估降压药物的使用与青光眼发病之间的关联。

结果

共分析了 6748 例病例和 13496 例对照。与对照组相比,青光眼患者中使用降压药物的比例略高(46.9%比 46.0%,p>0.05)。调整人口统计学、健康相关因素和病史后,降压药物的使用与青光眼发病之间无显著关联(OR 0.95,95%CI=0.89-1.02)。对于特定亚型,只有β受体阻滞剂(BBA)(OR 0.82,95%CI=0.75-0.90)和利尿剂(OR 0.85,95%CI=0.77-0.95)与降低青光眼发病风险显著相关。

结论

本研究表明,降压药物的使用与青光眼发病无关。BBA 和利尿剂使用者青光眼发病风险降低需要进一步验证。

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