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Cardiovascular medication and intraocular pressure: results from the Gutenberg Health Study
  1. René Höhn1,2,
  2. Alireza Mirshahi1,3,
  3. Stefan Nickels1,
  4. Andreas Schulz4,
  5. Philipp S Wild4,5,6,
  6. Maria Blettner7,
  7. Norbert Pfeiffer1
  1. 1 Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
  2. 2 Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
  3. 3 Dardenne Eye Clinic, Bonn-Bad Godesberg, Godesberg, Germany
  4. 4 Preventive Cardiology and Preventive Medicine/Center for Cardiology, University, Medical Center Mainz, Mainz, Germany
  5. 5 Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
  6. 6 German Center of Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
  7. 7 Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
  1. Correspondence to Dr René Höhn, Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; Rene.Hoehn{at}


Background Intraocular pressure (IOP) is well known to be associated with blood pressure and other cardiovascular risk factors. The influence of systemic cardiovascular, in particular antihypertensive, medication on IOP is still controversial. This study analyses the association between the use of cardiovascular medications and IOP in a large European cohort.

Methods The Gutenberg Health Study is a population-based, prospective,observational cohort study in mid-western Germany. IOP was measured using a non-contact tonometer. The medication classes examined were peripheral vasodilators, diuretics, β-blockers (overall, selective and non-selective), calcium channel blockers, renin–angiotensin blockers (overall, ACE inhibitors and angiotensin-receptor blockers), nitrates, other antihypertensive medications, aspirin and statins. Subjects with missing IOP values, topical IOP-lowering medication or previous ocular surgery were excluded. In total, 13 527 subjects were enrolled in this study. Association analyses between medication use and IOP were performed using multivariable linear regression (p<0.0038).

Results Neither selective nor non-selective systemic β-blocker intake was associated with statistically significant lower IOP (−0.12 mm Hg, p=0.054 and −0.70 mm Hg, p=0.037, respectively). IOP was not associated with the use of ACE inhibitors after adjustment for body mass index, systolic blood pressure and central corneal thickness (0.11 mm Hg; p=0.07).

Conclusions None of the cardiovascular medications, in particular systemic β-blocking agents, showed an association with IOP in non-glaucoma subjects. The long-term drift phenomenon of topical and systemic β-blocker might explain this result. Our results suggest that systemic β-blockers have a negligible effect on IOP reduction.

  • Intraocular pressure
  • beta-blocker
  • cardiovascular medication
  • population-based cohort
  • long-term drift

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  • Contributor RH designed the study, collected and interpreted data and wrote the paper. AM, SN, PSW, MB and NP designed the study, interpreted the data and critical revised the paper. AS analysed and interpreted the data and critical revised the paper.

  • Competing interests None declared.

  • Patient consent According to the tenets of the Declaration of Helsinki, written informed consent was obtained from all participants prior to their entry into the study.

  • Ethics approval The study protocol and study documents were approved by the local ethics committee of the Medical Chamber of Rhineland-Palatinate, Germany (reference no. 837.020.07; original vote: 22.3.2007, latest update: 20.10.2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.