Development of additive systemic effects when taking β-blockers in patients with glaucoma and concurrent chronic diseases

Abstract

To assess the frequency and extent of adverse reactions at simultaneous local and systemic prescription of β-blockers to patients with glaucoma and systemic vascular pathology. The study included 112 patients that have been taking β-blockers for at least 6 months. The main group consisted of 39 patients with primary open-angle glaucoma (POAG) in combination with cardiovascular disease; the first comparison group - 36 patients with POAG without systemic vascular pathology; the second comparison group - 37 patients with systemic vascular pathology without glaucoma. In the main and first comparison groups, double instillations of 0.5% timolol or 0.5% betaxolol were used as monotherapy. Adverse reactions to the long-term usage of β-blockers were found in 82% of the main group patients with cardiovascular diseases. They manifested as bradycardia or bronchospasm (38% patients), combination of bradycardia and vascular hypotension or bronchospasm (18%), or combination of 3-4 types of adverse reactions (26%); in the first and second comparison groups - in 36% and 30%, respectively (p<0.05). The most severe multifactorial adverse reactions developed due to long-term use of combinations of systemic and local β-blockers: 100 mg metoprolol or 10 mg bisoprolol with 0.5% timolol.