title: Patients with Primary Open-Angle Glaucoma May Develop Ischemic Heart Disease More Often than Those without Glaucoma: An 11-Year Population-Based Cohort Study.
abstract: OBJECTIVE
  To investigate whether patients with primary open angle glaucoma (POAG) have a higher proportion of ischemic heart disease (IHD) development.
  
  
  METHODS
  A population-based retrospective cohort study, using the National Health Insurance Database (NHID) from 1st January, 2001, to 31st December, 2011, in Taiwan.
  
  
  METHODS
  3510 subjects with POAG were enrolled into the POAG group and 14040 subjects without glaucoma into the comparison group. The comparison group consisted of randomly selected individuals, matched with the POAG group based on age, gender, and index date (date of enrollment) at a ratio of 1:4. The participants of both groups should have no IHD before the index date, and they were followed until the end of 2011 to see whether they had new-onset IHD or not. Kaplan-Meier curves were used to compare the cumulative incidence of IHD between the two groups. Frailty model, a specialized form of Cox regression analysis, was used to estimate the crude and adjusted hazard ratio (HR) of IHD. Analyses were adjusted by age, gender, and systemic comorbidities (i.e. diabetes, hypertension, hyperlipidemia, atrial fibrillation and congestive heart failure).
  
  
  RESULTS
  The mean age of the cohort was 57.6±11.0 years. There were slightly more males than females (51.6% vs. 48.4%). A log-rank test comparing Kaplan-Meier curves of the two groups revealed a significantly higher cumulative incidence of IHD in the POAG group (p-value<0.001). In the univariate analysis by Frailty model, POAG patients had a significantly higher hazard of IHD (unadjusted HR = 2.32; 95% confidence interval 1.93 to 2.79). After adjustment, results remained significant (adjusted HR = 1.41; 95% confidence interval 1.16 to 1.72).
  
  
  CONCLUSIONS
  People with POAG may suffer from IHD more often than those without glaucoma.
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan.|Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yu-Yen
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.|Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.|Deputy Superintendent, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Dachen
authors.initials: D
authors.lastname: Chu
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.|Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.|Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
authors.forename: Chin-Kuo
authors.initials: CK
authors.lastname: Chang
authors.affiliation: Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005902:Glaucoma, Open-Angle / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D012306:Risk; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology