title: Association of the optic disc structure with the use of antihypertensive medications: the thessaloniki eye study.
abstract: OBJECTIVE
  To investigate the association of antihypertensive medications with optic disc structure by blood pressure (BP) level, in nonglaucoma subjects.
  
  
  METHODS
  Cross-sectional, population-based study.
  
  
  METHODS
  A subset of Thessaloniki Eye Study participants was included in this study. Subjects were interviewed for medical history and underwent extensive ophthalmic examination, BP measurement, and optic disc imaging with the Heidelberg retinal tomograph. Subjects treated for hypertension were grouped in the following groups: (1) angiotensin-converting enzyme inhibitors and/or angiotensin-receptor blockers; (2) beta blockers and/or calcium-channel blockers; (3) diuretics alone or combined with others; and (4) other combinations. Cup size and cup-to-disc (C/D) ratio in the above groups were compared with the untreated group, using regression models. Analyses were rerun for subjects with systolic BP (SBP)<140 mm Hg, SBP≥140 mm Hg, diastolic BP (DBP)<90 mm Hg, and DBP≥90 mm Hg.
  
  
  RESULTS
  Among 232 subjects, 131 were receiving antihypertensive medications. In subjects with DBP<90 mm Hg, all medications groups were associated with larger cup size and higher C/D ratio compared with the untreated group. Results were similar in subjects with SBP<140 mm Hg, with the exception of the beta blockers and/or calcium-channel blockers group. None of the medications groups were associated with the Heidelberg retinal tomograph parameters in those with DBP≥90 mm Hg or SBP≥140 mm Hg.
  
  
  CONCLUSIONS
  All classes of antihypertensive medications were associated with larger cup size and higher C/D ratio in subjects with either DBP<90 mm Hg or SBP<140 mm Hg. These results suggest that there is no specific medication-related effect on optic disc structure, and the associations found are mediated through the hypotensive effect of antihypertensive medications.
authors.affiliation: Department of Ophthalmology, Indiana University, School of Medicine, Indianapolis, IN, USA.
authors.forename: Alon
authors.initials: A
authors.lastname: Harris
authors.forename: Fotis
authors.initials: F
authors.lastname: Topouzis
authors.forename: M Roy
authors.initials: MR
authors.lastname: Wilson
authors.forename: Panayiota
authors.initials: P
authors.lastname: Founti
authors.forename: Nisha Shah
authors.initials: NS
authors.lastname: Kheradiya
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Anastasopoulos
authors.forename: Gordon
authors.initials: G
authors.lastname: Gong
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Christian P
authors.initials: CP
authors.lastname: Jonescu-Cuypers
authors.forename: Theofanis
authors.initials: T
authors.lastname: Pappas
authors.forename: Archimidis
authors.initials: A
authors.lastname: Koskosas
authors.forename: Anne L
authors.initials: AL
authors.lastname: Coleman
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D001795:Blood Pressure Determination; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D009898:Optic Disk / Q000473:pathology*; D014054:Tomography
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics