Abstract
Abstract: :
Purpose: In order to assess the importance of the vascular risk factors in patients with primary open–angle glaucoma (POAG), data from the medical history of about 3,000 POAG patients and 1,000 age–matched controls were collected and analyzed. Methods: Thirty–six Italian academic centers participated in this observational study. Included were consecutive patients with POAG (diagnosed on the basis of glaucomatous optic disc and visual field changes) and a group of age–matched controls (IOP < 21 mmHg, normal field and normal disc, absence of family history of POAG). Excluded were patients with ocular hypertension, angle–closure glaucoma, any previous eye surgery and proliferative diabetic retinopathy. Data concerning vascular risk factors were collected for all patients with a questionnaire including life habits, smoking, drinking, migraine, etc.. A complete ophthalmological examination with assessment of IOP and systemic blood pressure was also performed. The ESH–ESC (European Society of Hypertension–European Society of Cardiology) guidelines were used to calculate the level of cardiovascular risk (5 levels of risk). Crude and adjusted estimates of the odds ratios were calculated for all cardiovascular risk factors in POAG groups and controls. Results:A total of 3,852 patients (2,879 POAG and 973 controls) were included in this study. Adjusted mean blood pressures were similar in POAG and controls, though glaucoma cases had a significantly higher systolic blood pressure as compared with controls (139.1 vs 136.0 mm Hg, p < 0.01). Also mean IOP was significantly higher in POAG group (16.7 vs 15.5 mm Hg, p < 0.01), while diastolic perfusion pressure was not significantly different in the 2 groups (65.4 vs 66.0, NS). Myopia was more prevalent in POAG group (23.4% vs 17.5%, p < 0.01) as well as a positive family history for the disease (25.9% vs 11.9%, p < 0.01). POAG patients tended to have a higher cardiovascular risk than controls: 63.4% of glaucoma cases vs 55.6 % of controls (OR 1.38, 95% C.I. 1.2–1.6, p < 0.01) had a "high" or "very high" cardiovascular risk. No significant difference between severe and mild/moderate POAG cases was found. Conclusions: Cardiovascular risk factor was significantly higher in glaucoma patients than in controls. Heart disease, "claudicatio intermittens" and carotid occlusion were the pathologies more frequently associated with POAG.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • clinical (human) or epidemiologic studies: prevalence/incidence