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Michele N. Pham, Mauro T. Leite, Christopher Bowd, Christopher A. Girkin, Jeffrey M. Liebmann, Felipe A. Medeiros, Pamela A. Sample, Robert N. Weinreb, Linda M. Zangwill; Blood Pressure and Perfusion Pressure Risk Factors for Open Angle Glaucoma in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Innovations in Glaucoma Study (DIGS). Invest. Ophthalmol. Vis. Sci. 2011;52(14):5026.
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To describe the relationship between open angle glaucoma (OAG) and vascular risk factors, including blood pressure and perfusion pressure, in individuals of African descent (AD) and European descent (ED).
535 healthy controls (275 AD and 260 ED) and 653 glaucoma patients (338 AD and 315 ED) were included in these cross-sectional observational studies. Univariable and multivariable logistic regression models were built to evaluate the relationship of age, race, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MBP), systolic perfusion pressure (SPP), diastolic perfusion pressure (DPP), mean perfusion pressure (MPP) and intraocular pressure (IOP) and the probability of having glaucoma.
AD participants were younger and had, on average, higher SBP, DBP, MBP, DPP and MPP when compared to individuals of ED. Each 10mmHg incremental increase in SBP resulted in a 31% and 16% increase in the probability of glaucoma in ED and AD, respectively. [ED: OR (95% CI)=1.31 (1.17 to 1.48); AD: OR (95% CI)=1.16 (1.05 to 1.03)]. However, both associations lost significance after adjusting for age. There was no statistically significant correlation between the perfusion pressure tertiles and glaucoma in ADs. In EDs, the highest SPP tertile was associated with having POAG [OR(95%C)=2.22 (1.43-3.43)], but after adjusting for IOP-lowering treatment, the relationship was no longer statistically significant.
A lower perfusion pressure was not associated with the probability of glaucoma in either the European descent group or the African descent group. The lack of association may be due in part to the complex relationship between age, IOP, BP, and IOP and BP-lowering treatment.
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