Using the All of Us Research Program database, researchers sought to assess the relationship between blood pressure (BP), BP medicines, and glaucoma. A retrospective, longitudinal cohort research that made use of the National Institutes of Health’s national electronic health record (EHR) database. Patients have at least 15 months of follow-up and one blood pressure measurement in the All of Us Research Program database. Cox regression models, both univariate and multivariate, predicted the probability of acquiring incident open-angle glaucoma (OAG). In order to account for variations over time, mean arterial pressure (MAP) and the number of BP drug classes were input as time-varying predictors.
OAG was developed in 462 of the 20,815 eligible eye patients who qualified for this research. Low blood pressure (MAP 83.0 mmHg) was linked to an increased chance of developing OAG (hazard ratio [HR], 1.32; 95% CI, 1.04–1.67). After controlling for confounders, high blood pressure (MAP>101.3 mmHg) and the number of BP drug classes were not linked with OAG. Other risk variables for OAG were race (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), age (80+ years, HR, 20.1, 95% CI, 9.10–44.5), and diabetes (HR, 1.32, 95% CI, 1.04–1.67). The female gender was related to a lower risk of acquiring OAG (HR, 0.66, 95% CI, 0.55–0.80). There was no significant relationship between MAP and the number of BP medicines used and the chance of developing OAG.
In a nationwide longitudinal EHR database, investigators discovered that low blood pressure is related to an increased chance of developing OAG. They found no evidence to show a difference between medically treated and untreated low blood pressure. The work contributed to the body of data supporting vascular dysregulation as a possible etiology for the development of OAG, highlighting the lack of impact of blood pressure drugs on the association.
Reference:www.aaojournal.org/article/S0161-6420(21)00819-8/fulltext
