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Increased Risks of Open-Angle Glaucoma in Untreated Hypertension
Jihei Sara Lee1, Yong Joon Kim1, Sunyeup Kim2
1Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University, South Korea.
Insights
Elevated blood pressure, including stage 1 hypertension, significantly increases the risk of developing open-angle glaucoma (OAG). This risk escalates with higher untreated blood pressure levels, highlighting the importance of BP management for OAG prevention.
Area of Science:
- Ophthalmology
- Cardiology
- Public Health
Background:
- Hypertension (HTN) is a known comorbidity of open-angle glaucoma (OAG).
- The specific risk posed by elevated blood pressure (BP) alone and by stage 1 HTN, according to 2017 ACC/AHA guidelines, for OAG development remains uncertain.
Purpose of the Study:
- To investigate the association between untreated elevated blood pressure and the risk of developing open-angle glaucoma (OAG).
- To determine if stage 1 hypertension, as defined by 2017 ACC/AHA guidelines, is a significant risk factor for OAG.
Main Methods:
- Retrospective, observational cohort study including 360,330 subjects aged 40+.
- Subjects were categorized by untreated BP: normal, elevated, stage 1 HTN, and stage 2 HTN.
- Cox regression analysis was used to calculate hazard ratios (HR) for OAG risk over an average 11.76-year follow-up.
Main Results:
- Over 11.76 years, 3.56% of subjects were diagnosed with OAG.
- Multivariable-adjusted HRs for OAG were 1.056 for elevated BP, 1.101 for stage 1 HTN, and 1.114 for stage 2 HTN, compared to normal BP.
- A dose-response relationship was observed between increasing untreated BP and OAG risk.
Conclusions:
- The risk of developing OAG increases with higher levels of untreated blood pressure.
- Stage 1 hypertension, per 2017 ACC/AHA guidelines, is identified as a significant risk factor for open-angle glaucoma.
Purpose:
Hypertension (HTN) has been associated with open-angle glaucoma (OAG), but whether elevated blood pressure (BP) alone is associated with OAG is unknown. Whether stage 1 hypertension, as per the 2017 American College of Cardiology/American Heart Association (ACC/AHA) BP guidelines, increases the risk of the disease is uncertain.
Design:
Retrospective, observational, cohort study.
Methods:
A total of 360,330 subjects who were ≥40 years of age and not taking antihypertensive or antiglaucoma drugs at the time of health examinations between January 1, 2002, and December 31, 2003, were included. Subjects were categorized based on their untreated BP, into normal BP (systolic BP [SBP] <120 and diastolic BP [DBP] <80 mm Hg; n = 104,304), elevated BP (SBP 120-129 and DBP <80 mm Hg; n = 33,139), stage 1 HTN (SBP 130-139 or DBP 80-89 mm Hg; n = 122,534), or stage 2 HTN (SBP ≥140 or DBP ≥90mm Hg; n = 100,353). Cox regression analysis was performed to calculate hazard ratios (HR) of OAG risk.
Results:
The mean age of the subjects was 51.17 ± 8.97 years, and 56.2% were male. During a mean follow-up period of 11.76 ± 1.37 years, 12,841 subjects (3.56%) were diagnosed with OAG. Multivariable-adjusted HRs (95% CIs) were 1.056 (0.985-1.132) for elevated BP, 1.101(1.050-1.155) for stage 1 HTN, and 1.114(1.060-1.170) for stage 2 HTN with normal BP as the reference.
Conclusions:
The risk for OAG becomes greater with increases in untreated BP. Stage 1 HTN per the 2017 ACC/AHA BP guidelines is a significant risk factor for OAG.
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