title: The effect of antihypertensive therapy on dry eye disease.
abstract: BACKGROUND
  There is a generalization that "antihypertensive (antiHT) therapy causes Dry Eye Syndrome", which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function.
  
  
  OBJECTIVE
  The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms.
  
  
  METHODS
  Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic -). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB -) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month.
  
  
  RESULTS
  The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0-1st month) and the third month (0-3rd months) control measurements between diuretics (+) and diuretics (-) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0-1st month measurements of ACE/ARB (+) and ACE/ARB (-) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022).
  
  
  CONCLUSIONS
  The use of antiHT drugs containing diuretic had no adverse effect on the tear function tests, but using drugs that contain ACE/ARB could have a positive impact.
authors.affiliation: Department of Ophthalmology, Yildirim Beyazit Universty Medical Faculty Ankara Ataturk Training and Research Hospital , Ankara , Turkey .
authors.forename: Emine
authors.initials: E
authors.lastname: Kalkan Akcay
authors.forename: Murat
authors.initials: M
authors.lastname: Akcay
authors.forename: Gamze Dereli
authors.initials: GD
authors.lastname: Can
authors.forename: Nabi
authors.initials: N
authors.lastname: Aslan
authors.forename: Betul Seher
authors.initials: BS
authors.lastname: Uysal
authors.forename: Basak Bostanci
authors.initials: BB
authors.lastname: Ceran
authors.forename: Pinar
authors.initials: P
authors.lastname: Koseahya
authors.forename: Nurullah
authors.initials: N
authors.lastname: Cagil
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015352:Dry Eye Syndromes / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears
chemical_list: D000959:Antihypertensive Agents
keywords: Antihypertension medicals; dry eye; tear osmolarity