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Systemic hypertension and glaucoma: mechanisms in common and co-occurrence
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  1. M J S Langman1,
  2. R J Lancashire2,
  3. K K Cheng2,
  4. P M Stewart1
  1. 1Department of Medicine, University of Birmingham, Birmingham, UK
  2. 2Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
  1. Correspondence to: Professor M Langman Department of Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK; m.j.s.langmanbham.ac.uk

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

  • Financial support from the Wellcome Trust is gratefully acknowledged. PMS was a Medical Research Council Senior Fellow.

  • Competing interests: none declared

  • Ethical approval was obtained from the ethics committee responsible for GPRD.

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