Systemic hypertension and glaucoma: mechanisms in common and co-occurrence.
OBJECTIVE
To determine whether systemic hypertension and glaucoma might coexist more often than expected, with possible implications for treatment.


METHODS
Case-control study using general practitioner database of patients with glaucoma matched with controls for age and sex.


RESULTS
Hypertension was significantly more common in the 27,080 patients with glaucoma (odds ratio 1.29, 95% confidence intervals 1.23 to 1.36, p<0.001) than in controls. Treatment by oral beta blockade appeared to protect from risk (odds ratio 0.77, 95% CI 0.73 to 0.83, p<0.0001), but oral calcium channel antagonists or angiotensin converting enzyme (ACE) inhibitors did not (odds ratios 1.34, 1.24 to 1.44 and 1.16 1.09-1.24, respectively, p<0.0001 in each case). Oral corticosteroid treatment was associated with enhanced risk (odds ratio 1.78, 1.61 to 1.96).


CONCLUSIONS
Common pathogenetic mechanisms in ciliary and renal tubular epithelia may explain coincidence of glaucoma and systemic hypertension. The choice of cardiovascular treatment, could substantially influence glaucoma incidence, with beta blockade protecting and ACE inhibitors or calcium channel blockers not affecting underlying risk.
Langman
M J S
MJ
Department of Medicine, University of Birmingham, Birmingham B15 2TH, UK. m.j.s.langman@bham.ac.uk
Lancashire
R J
RJ
Cheng
K K
KK
Stewart
P M
PM
D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016022:Case-Control Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005901:Glaucoma / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers