Open-angle glaucoma and systemic hypertension: The Blue Mountains eye study. Mitchell P, Lee AJ, Rochtchina E, Wang JJ. J Glaucoma 2004;13:319–326.

Abstract

Data from the Blue Mountains Eye Study were used to determine systemic hypertension is associated with primary open-angle glaucoma (POAG) in an older population. The Blue Mountains Eye Study examined 3654 subjects aged 49 to 47 years. Hypertension was diagnosed from history in treated subjects or from systolic blood pressure (BP) ≥ 160 mm Hg or diastolic BP ≥ 95 mm Hg. POAG as diagnosed from congruous optic disk rim thinning and visual field loss, without reference to intraocular pressure (IOP) level. Ocular hypertension (OHT) was defined when IOP was > 21 mm Hg in either eye, among patients without POAG. Hypertension was present in 45.7% of subjects, POAG in 3.0%, and OHT in 5.2%. Hypertension was significantly associated with POAG, after adjustment for POAG risk factors, including IOP with an odds ratio (OR) 1.56 and 95% confidence interval (CI) 1.01–2.40. This relation was strongest in subjects with poorly controlled hypertension (POAG prevalence 5.4%), compared with normotensive subjects (POAG prevalence 1.9%), independent of IOP (OR 1.88, CI 1.09–3.25). The population-attributable risk for hypertension (20.4%) was higher than for other identified POAG risk factors. The prevalence of OHT was 8.1% in subjects with poorly controlled hypertension (OR 1.81, CI 1.20–2.73) and 8.2% in untreated hypertension (OR 1.96, CI 1.31–2.95), compared to 4.2% in normotensive subjects. Hypertension, particularly if poorly controlled, appears related to a modest, increased risk of POAG, independent of the effect of BP on IOP and other glaucoma risk factors. Hypertension was also associated with OHT, a relationship that could in part reflect the influence of BP on IOP. Data from the Blue Mountains Eye Study were used to determine systemic hypertension is associated with primary open-angle glaucoma (POAG) in an older population. The Blue Mountains Eye Study examined 3654 subjects aged 49 to 47 years. Hypertension was diagnosed from history in treated subjects or from systolic blood pressure (BP) ≥ 160 mm Hg or diastolic BP ≥ 95 mm Hg. POAG as diagnosed from congruous optic disk rim thinning and visual field loss, without reference to intraocular pressure (IOP) level. Ocular hypertension (OHT) was defined when IOP was > 21 mm Hg in either eye, among patients without POAG. Hypertension was present in 45.7% of subjects, POAG in 3.0%, and OHT in 5.2%. Hypertension was significantly associated with POAG, after adjustment for POAG risk factors, including IOP with an odds ratio (OR) 1.56 and 95% confidence interval (CI) 1.01–2.40. This relation was strongest in subjects with poorly controlled hypertension (POAG prevalence 5.4%), compared with normotensive subjects (POAG prevalence 1.9%), independent of IOP (OR 1.88, CI 1.09–3.25). The population-attributable risk for hypertension (20.4%) was higher than for other identified POAG risk factors. The prevalence of OHT was 8.1% in subjects with poorly controlled hypertension (OR 1.81, CI 1.20–2.73) and 8.2% in untreated hypertension (OR 1.96, CI 1.31–2.95), compared to 4.2% in normotensive subjects. Hypertension, particularly if poorly controlled, appears related to a modest, increased risk of POAG, independent of the effect of BP on IOP and other glaucoma risk factors. Hypertension was also associated with OHT, a relationship that could in part reflect the influence of BP on IOP.