Hypotensive medication, statins, and the risk of glaucoma

PURPOSE. To examine whether treatment with oral blood-pressure-lowering medication or statins influences the risk of glaucoma. METHODS. This study was a case-control investigation, nested within a computerized primary care database of 177 general practices across the United Kingdom; 8778 cases diagnosed and/or treated for glaucoma between 2000 and 2007, and 8778 glaucoma-free controls matched for age, sex, and practice. Odds ratios for treatment with oral antihypertensives (including selective beta(1) and nonselective beta-blockers) and statins in the 5 years before diagnosis were calculated by logistic regression, adjusted for a marker of socioeconomic position and number of drug types prescribed (as a measure of health service usage). RESULTS. Prevalence of oral beta-blocker use in the 5 years before diagnosis was lower in the cases (22.5%) than in the controls (23.6%), adjusted odds ratio (OR) 0.87 (95% confidence interval [CI], 0.80-0.94). This effect was presence with treatment with beta(1)-selective medications (OR, 0.81; 95% CI, 0.74-0.88) but not with nonselective medications (OR, 1.08; 95% CI, 0.94-1.24). The prevalence of thiazide use was higher among the glaucoma cases than among the controls (OR, 1.13; 95% CI, 1.04-1.23). Neither statins nor other antihypertensive treatments were associated with the risk of glaucoma. CONCLUSIONS. Oral beta(1) beta-blockers may protect against development of glaucoma. The current consensus on the relative importance of beta(2) receptor blockade in treating glaucoma may have to be reviewed. Changes in prescribing oral beta-blockers for cardiovascular disorders may affect the number of those who eventually have glaucoma. There is no evidence to suggest that statins have a preventive role in glaucoma.