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BB Nemesure, SY Wu, A Hennis, MC LeskeBarbados Eye Studies Group; Four-Year Incidence of "High" Intraocular Pressure and Related Factors - The Barbados Eye Studies . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2946.
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Purpose: To evaluate the 4-year incidence of elevated intraocular pressure (IOP) and associated factors in a predominantly black population. Methods: This report is based on 3427 (85% of those eligible) Barbados Incidence Study of Eye Disease (BISED) participants who were re-examined four years after their baseline visit. Incidence of elevated IOP was determined at various cutoff values, after excluding individuals with baseline IOP≷21mmHg/treatment or any glaucoma diagnosis. Associations of high IOP with possible risk factors were evaluated using polychotomous logistic regression. Results: At baseline, 2495 black participants had IOP ≤21 mmHg and no glaucoma. Using a cutoff of IOP≷21 mmHg (representing the 80th percentile in this population) at baseline, the 4-year incidence of "high" IOP (not attributable to glaucoma) among this group was 12.9% (95% confidence interval (11.7%, 14.3%)). For IOP≷24 mmHg (90th percentile), incidence was 5.8% (4.9%, 6.8%); and for IOP≷28 mmHg (95th percentile) incidence was 1.8% (1.3%, 2.4%). Factors associated with high IOP included older age, higher baseline IOP, hypertension, systolic (SBP) and diastolic blood pressure (DBP). Although persons with 21<IOP≤28 mmHg tended to have higher SBP (medians from 140-141 mmHg) and DBP (medians from 82-85 mmHg), those with IOP≤21 mmHg and IOP≷28 mmHg had lower BP values (median SBP and DBP of 129/80 and 129/78 mmHg, respectively). Conclusion: Given the IOP distribution in this Afro-Caribbean population, definition of "high" IOP may be more relevant if based on cut-offs representing the 90th-95th percentiles rather than if based on arbitrary values. Older individuals and those with higher baseline IOP were more likely to develop elevated IOP after four years. Although BP was associated with elevated IOP, the relationship may not be linear and requires further investigation.
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