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Hypertension ups risk of developing open-angle glaucoma

4 months ago

Open-angle glaucoma (OAG) is more likely to occur in patients diagnosed with systemic hypertension (HTN) than those without HTN, according to a recent study.

An 11-year nationwide cohort study was conducted to assess the association between OAG and HTN. Included were patients with HTN and a matched comparison cohort from the Korean National Health Insurance Service National Sample Cohort database.

The HTN group consisted of patients who were prescribed antihypertensive medication, or those with systolic blood pressure (SBP) of at least 140 mm Hg or diastolic blood pressure (DBP) of at least 90 mm Hg. The OAG group was composed of patients satisfying the OAG criteria during repeated visits to an ophthalmologist.

Researchers used the Charlson comorbidity index to control for systemic conditions and performed Cox proportional hazard regression analysis.

OAG occurred in 1,961 (2.0 percent) patients in the HTN group and in 1,692 (1.7 percent) in the comparison group (p<0.001). The respective OAG incidence rates in patients with and without HTN were 19.0 and 16.4 per 10,000 person-years.

Based on multivariable Cox model, there was an association between HTN and an increased OAG incidence (adjusted hazard ratio [HR], 1.16; 95 percent CI, 1.09 to 1.24).

Subsequent OAG was more likely to occur in participants with higher SBP (adjusted HR, 1.12 for 120 to 139 mm Hg group; and adjusted HR, 1.20 for ≥140 mm Hg group) than in those who had SBP of <120 mm Hg. In addition, similar trends were seen in participants with higher DBP (adjusted HR, 1.11 for 80 to 89 mm Hg group; and adjusted HR, 1.07 for ≥90 mmHg group) and those with <80 mm Hg DBP.

A study by Newmann-Casey et al had similar observations, which found an increased hazard of developing OAG in individuals with HTN (HR, 1.17; 1.13 to 1.22) or diabetes mellitus (HR, 1.35; 1.21 to 1.50) or in combination (HR, 1.48; 1.39 to 1.58) relative to those without these conditions. [Ophthalmology 2011;118:1318-26]

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Regardless of dosing, nonvitamin K antagonist oral anticoagulants (NOACs) are more effective than warfarin for atrial fibrillation and safer in Asian than in non-Asian populations, a new meta-analysis shows.
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