title: Cardiovascular medication and intraocular pressure: results from the Gutenberg Health Study.
abstract: Intraocular pressure (IOP) is well known to be associated with blood pressure and other cardiovascular risk factors. The influence of systemic cardiovascular, in particular antihypertensive, medication on IOP is still controversial. This study analyses the association between the use of cardiovascular medications and IOP in a large European cohort.
  
  
  
  The Gutenberg Health Study is a population-based, prospective,observational cohort study in mid-western Germany. IOP was measured using a non-contact tonometer. The medication classes examined were peripheral vasodilators, diuretics, β-blockers (overall, selective and non-selective), calcium channel blockers, renin-angiotensin blockers (overall, ACE inhibitors and angiotensin-receptor blockers), nitrates, other antihypertensive medications, aspirin and statins. Subjects with missing IOP values, topical IOP-lowering medication or previous ocular surgery were excluded. In total, 13 527 subjects were enrolled in this study. Association analyses between medication use and IOP were performed using multivariable linear regression (p<0.0038).
  
  
  
  Neither selective nor non-selective systemic β-blocker intake was associated with statistically significant lower IOP (-0.12 mm Hg, p=0.054 and -0.70 mm Hg, p=0.037, respectively). IOP was not associated with the use of ACE inhibitors after adjustment for body mass index, systolic blood pressure and central corneal thickness (0.11 mm Hg; p=0.07).
  
  
  
  None of the cardiovascular medications, in particular systemic β-blocking agents, showed an association with IOP in non-glaucoma subjects. The long-term drift phenomenon of topical and systemic β-blocker might explain this result. Our results suggest that systemic β-blockers have a negligible effect on IOP reduction.
authors.affiliation: Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.|Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
authors.forename: René
authors.identifier: 0000-0003-2870-1469
authors.initials: R
authors.lastname: Höhn
authors.affiliation: Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.|Dardenne Eye Clinic, Bonn-Bad Godesberg, Godesberg, Germany.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirshahi
authors.affiliation: Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Nickels
authors.affiliation: Preventive Cardiology and Preventive Medicine/Center for Cardiology, University, Medical Center Mainz, Mainz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulz
authors.affiliation: Preventive Cardiology and Preventive Medicine/Center for Cardiology, University, Medical Center Mainz, Mainz, Germany.|Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany.|German Center of Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D002317:Cardiovascular Agents
keywords: Intraocular pressure; beta-blocker; cardiovascular medication; long-term drift; population-based cohort