Article Text
Abstract
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% CI 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.
- ACE, angiotensin converting enzyme
- GPRD, General Practitioner Research Database
- glaucoma
- hypertension
- β blockade
- sodium transport
- ACE, angiotensin converting enzyme
- GPRD, General Practitioner Research Database
- glaucoma
- hypertension
- β blockade
- sodium transport
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Footnotes
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Financial support from the Wellcome Trust is gratefully acknowledged. PMS was a Medical Research Council Senior Fellow.
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Competing interests: none declared
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Ethical approval was obtained from the ethics committee responsible for GPRD.
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