This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Langman, M J S Articles by Stewart, P M Search for Related Content PubMed PubMed Citation Articles by Langman, M J S Articles by Stewart, P M Topic Collections Relevant Article

Systemic hypertension and glaucoma: mechanisms in common and co-occurrence

¹ Department of Medicine, University of Birmingham, Birmingham, UK
² Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK

Correspondence to:
Correspondence to:
Professor M Langman
Department of Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK; m.j.s.langman{at}bham.ac.uk

ABSTRACT
Aims: To determine whether systemic hypertension and glaucoma might coexist more often than expected, with possible implications for treatment.

Methods: Case-control study using general practitioner database of patients with glaucoma matched with controls for age and sex.

Results: Hypertension was significantly more common in the 27 080 patients with glaucoma (odds ratio 1.29, 95% confidence intervals 1.23 to 1.36, p<0.001) than in controls. Treatment by oral ß blockade appeared to protect from risk (odds ratio 0.77, 95% CI 0.73 to 0.83, p<0.0001), but oral calcium channel antagonists or angiotensin converting enzyme (ACE) inhibitors did not (odds ratios 1.34, 1.24 to 1.44 and 1.16 1.09–1.24, respectively, p<0.0001 in each case). Oral corticosteroid treatment was associated with enhanced risk (odds ratio 1.78, 1.61 to 1.96).

Conclusion: Common pathogenetic mechanisms in ciliary and renal tubular epithelia may explain coincidence of glaucoma and systemic hypertension. The choice of cardiovascular treatment, could substantially influence glaucoma incidence, with ß blockade protecting and ACE inhibitors or calcium channel blockers not affecting underlying risk.

Abbreviations: ACE, angiotensin converting enzyme; GPRD, General Practitioner Research Database

Keywords: glaucoma; hypertension; ß blockade; sodium transport

Relevant Article

BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2005 89: 931. [Extract] [Full Text] [PDF]