Abstract
Purpose:
Sartan drugs are typically prescribed to treat a number of common diseases, such as hypertension and heart disease. Previous studies have shown the beneficial effect of Sartan drugs on reducing intraocular pressure and retinal ganglion cell death. Here, we test the hypothesis that Sartan drugs reduce primary open angle glaucoma (POAG) by exploring a large database of de-identified electronic medical records at Vanderbilt University Medical Center.
Methods:
Synthetic Derivative (SD), a database containing clinical information of > 2.2 million unique individuals who received care at Vanderbilt Medical Center was used to identify individuals for this study. Subjects who were 65 years or older as of August, 2008 with more than 1 clinic note during the study period (August, 2008 - August, 2013) were included. Subjects with a possible diagnosis of glaucoma, defined by any of the 44 glaucoma-related ICD 9 codes, were excluded. Cases were defined as individuals with at least one year of continuous Sartan drug exposure during the study period. Controls were defined as individuals with no Sartan drug exposure. POAG development during the study period was defined by the ICD9 code 365.11. Primary analysis reviewed data from all patients, and secondary analysis subdivided the group based on race. Fisher’s exact test was used to determine significance.
Results:
Patient data was obtained from 13,700 Cases and 88,598 Controls. Of the total Cases, 115 patients (0.75%) developed POAG during the study period. In contrast, 1,611 Controls (1.82%) developed POAG, which is significantly higher than for Cases (p < 0.0001). Subgroup analysis showed a lower rate of POAG development in Caucasians compared to African Americans. In Caucasians, Cases consisted of 12,550 individuals, where 85 of these individuals (0.69%) developed POAG, which is significantly lower compared to the 1,337 (1.61%) individuals of the 82,879 Caucasian Controls (p < 0.0001). Of the African American Cases (n= 1,150), 20 patients (1.39%) developed POAG, significantly lower than the 274 patients (4.79%) of African American Controls (n= 5,719) (p < 0.0001).
Conclusions:
In all comparisons, patients who had taken Sartan drugs continuously for at least a year had a lower diagnostic rate of POAG compared to those who had not taken any Sartan drugs. Further prospective study to prove the beneficial effect of Sartan drugs in reducing glaucoma, is warranted.
Keywords: 459 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology •
413 aging