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Christina Keskini, Anne L Coleman, M Roy Wilson, Alon Harris, Fei Yu, Fotis Topouzis; Prevalence of systemic b-blocker use and limitations on b-blocker use in the general population and in glaucoma patients: The Thessaloniki Eye Study (TES). Invest. Ophthalmol. Vis. Sci. 2020;61(7):61.
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To determine the magnitude of current limitation on b-blocker (BB) use due to contraindications and define the impact of potential additional restriction, if evidence of reduced efficacy of topically administered BB in those receiving systemic BB is confirmed.
A total of 2554 randomly-selected subjects aged ≥60 years participated in TES. In order to determine current limitation on BB use, prevalence of BB contraindications was estimated in the general population, in glaucoma patients and in subjects treated with intraocular pressure (IOP)-lowering treatment (Tx). Bradycardia (bpm<60) and hypotension (SBP<90mmHg and/or DBP<60mmHg) were determined by clinical examination. Asthma and chronic obstructive pulmonary disease were defined by patients' medications. Potential additional restriction on BB use was assessed by estimating the prevalence of systemic BB use, the co-prescription of topical and systemic BB and the indications for BB use in the aforementioned groups. Regarding the BB indications, hypertension (HTN) was defined by clinical examination (SBP≥140mmHg and/or DBP≥90mmHg) and/or self-reported history of HTN and/or anti-HTN Tx, while acute myocardial infarction and migraines were defined by self-reported history.
The prevalence of systemic BB use was 20.7%, 18.8% and 14.8% in the general population, in glaucoma patients and in subjects with IOP-lowering Tx, respectively. Considerable HTN rates were detected in the general population, being significantly higher in glaucoma patients than in healthy subjects (88.7% Vs 79.9%; p=0.011), and in subjects with IOP-lowering Tx compared to those without IOP-lowering Tx (89.8% Vs 79.8%, p=0.004). No statistically significant differences were detected for the remaining BB indications and BB contraindications. Bradycardia was highly prevalent in glaucoma patients (13.0%). The frequency of topical BB use did not significantly differ between subjects receiving systemic BB Tx and those not receiving systemic BB Tx.
Significant bradycardia rates may limit topical BB administration as IOP-lowering Tx. Frequent systemic BB use and HTN could further restrict the use of BB as IOP-lowering Tx, if evidence of reduced efficacy of topical BB in those receiving systemic BB is confirmed. Systemic BB Tx seems not to be taken under consideration when prescribing IOP-lowering Tx.
This is a 2020 ARVO Annual Meeting abstract.
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