Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.
 

Learn about the flu shot, COVID-19 vaccine, and our masking policy »

Stanford Health Care

The association between blood pressure, blood pressure medications, and glaucoma in a nationwide electronic health records database. Ophthalmology Lee, E. B., Hu, W., Singh, K., Wang, S. Y. 2021

Abstract

PURPOSE: To measure the association between blood pressure, blood pressure medications, and glaucoma using the All of Us Research Program database.DESIGN: A retrospective, longitudinal cohort study leveraging a national electronic health records database administered by the National Institute of Health.SUBJECTS, PARTICIPANTS AND/OR CONTROLS: Eye patients in the All of Us Research Program database with at least fifteen months of follow up and one blood pressure (BP) measurement.METHODS, INTERVENTION, OR TESTING: Univariable and multivariable Cox regression models predicted the risk of developing incident open angle glaucoma (OAG). Mean arterial pressure (MAP) and the number of BP medication classes were entered as time-varying predictors to account for changes over time.MAIN OUTCOME MEASURES: The risk of developing incident OAG, as defined by billing diagnosis codes.RESULTS: Of 20815 eligible eye patients who qualified for this study, 462 developed OAG. Low blood pressure (MAP < 83.0 mmHg) was associated with increased risk of developing OAG (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.04 - 1.67). High blood pressure (MAP > 101.3 mmHg) and the number of BP medication classes were not associated with OAG after adjustment for covariates. Other risk factors associated with OAG included being Black (HR 3.31, 95% CI 2.63 - 4.17), Hispanic or Latino (HR 2.53, 95% CI 1.94 - 3.28), Asian (HR 2.22, 95% CI 1.24 - 3.97), older in age (80+ years, HR 20.1, 95% CI 9.10 - 44.5), and diabetic (HR 1.32, 95% CI 1.04 - 1.67). Female gender was associated with decreased hazard of developing OAG (HR 0.66, 95% CI 0.55 - 0.80). No significant interaction was observed between MAP and the number of BP medications on the risk of developing OAG.CONCLUSIONS: We found that low blood pressure is associated with increased risk of developing OAG in a national longitudinal electronic health records database. We did not find evidence supporting a differential effect of medically treated and untreated low BP. This study adds to the body of literature implicating vascular dysregulation as a potential etiology for the development of OAG, particularly emphasizing the lack of influence of blood pressure medications on this relationship.

View details for DOI 10.1016/j.ophtha.2021.10.018

View details for PubMedID 34688700