Abstract
Purpose :
Glaucoma and cardiovascular disease (CVD) are common in the elderly population. Although a few studies have proposed both conditions to share pathophysiologic mechanisms, inconsistent findings on their relationship exist in the literature. Thus, we performed a cross-sectional study to investigate the association between glaucoma and CVD in the 2019 California (CA) Medicare population.
Methods :
Using the 2019 CA Master Beneficiary Summary File and Standard Analytic Files of Part B Carrier Claim data files from the Centers for Medicare and Medicaid Services, patients with International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes for glaucoma were identified. Inclusion criteria were 65 years or older, CA residence, coverage with both Medicare Part A and B, and at least one Part B claim in 2019. The comparison group included all CA Medicare beneficiaries without glaucoma diagnosis. Demographic characteristics including age, sex, and race/ethnicity were extracted, along with Charlson Comorbidity Index (CCI) that served as an indicator for systemic comorbidities. The main outcome was CVD, which was defined by having at least one ICD-10 diagnosis code for the following: ischemic heart disease, congestive heart failure, valvular disease, angina, arrhythmias, myocardial infarction, stroke, cardiac arrest, or tamponade. Logistic regression models were performed to assess the association between glaucoma and CVD after adjusting for potential confounders mentioned above.
Results :
Among 2,717,346 patients who met the inclusion criteria, 411,099 (15%) had a glaucoma diagnosis. Glaucoma beneficiaries were more likely to be between the ages of 70 to 74 (24%), female (60%), white (58%), and had a CCI score of 1 to 2 (36%). Moreover, 188,458 (46%) glaucoma beneficiaries had a CVD diagnosis. On univariate analysis, glaucoma beneficiaries had a statistically significant increased odds of having CVD (odds ratio [OR]=1.38, P<0.001) compared to their non-glaucoma counterparts. After adjusting for confounders in the multivariable analysis, the association remained statistically significant (aOR=1.12, P<0.001).
Conclusions :
This study found glaucoma to be associated with CVD in the 2019 CA Medicare population. Further studies are needed to elucidate the mechanism that links the two diseases, and determine if glaucoma patients may benefit from early interventions for prevention of CVD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.