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Eric Shieh, Victoria Tseng, Fei Yu, Anne L Coleman; High Blood Pressure and Glaucoma Risk. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2729.
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© ARVO (1962-2015); The Authors (2016-present)
The relationship between blood pressure and glaucoma is controversial. The purpose of our study was to investigate the association between blood pressure and open angle glaucoma in the National Health and Nutrition Survey (NHANES) population.
The study consisted of participants in the 2005-2008 NHANES database who had frequency doubling technology visual fields, optic disc photos, and blood pressure data. The outcome of interest was a clinical diagnosis of glaucoma based on the Rotterdam criteria. The exposures of interest included systolic blood pressure (SBP) and diastolic blood pressure (DBP). Logistic regression modeling was performed to evaluate the association between each exposure and glaucoma, controlling for age, gender, ethnicity, education level, annual household income, prior cataract extraction, age-related macular degeneration, BMI, current smoking, diabetes, sleep apnea, and prior myocardial infarction. All analyses were weighted according to the NHANES multistage sampling design.
Of 3865 participants, 212 (5.5%) participants had glaucoma, corresponding to an overall population-weighted glaucoma prevalence of 3.7% in a weighted total of 83,643,392 participants. Mean SBP was statistically significantly higher in participants with glaucoma as compared to participants without glaucoma (129.7±1.7 vs. 124.0±0.4 mmHg, p<0.001). Mean DBP was not appreciably different between participants with and without glaucoma (72.9±1.0 vs. 72.8±0.3 mmHg, p=0.93). For every 10 mmHg increase in SBP, odds of glaucoma increased by 4% (adjusted OR 1.04, 95% CI 0.95-1.14). For every 10 mmHg increase in DBP, odds of glaucoma increased by 19%, a change that was statistically significant (adjusted OR 1.19, 95% CI 1.01-1.40).
Glaucoma may be associated with high blood pressure. In individuals with glaucoma, average SBP was close to the new 2017 American College of Cardiology (ACC)/American Heart Association (AHA) recommended cutoff point for the diagnosis of systolic hypertension, defined as SBP > 130 mmHg, while in individuals without glaucoma, average SBP was in the normal range. There was also a statistically significant association between higher DBP and glaucoma prevalence. These findings suggest that maintaining blood pressure at a physiologic level may help reduce glaucoma risk. A future study will assess the association between blood pressure medications and glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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