Increased incidence of open-angle glaucoma among hypertensive patients: an 11-year nationwide retrospective cohort study

Abstract

OBJECTIVE: To evaluate the risk of open-angle glaucoma (OAG) among patients with systemic hypertension (HTN).

METHODS: This retrospective propensity-score-matched cohort study included patients with HTN and a matched comparison cohort from the Korean National Health Insurance Service National Sample Cohort database. The HTN group was defined as patients who were prescribed antihypertensive medication, or SBP at least 140 or DBP at least 90 mmHg. The OAG group was defined as patients satisfying OAG criteria during repeated visits to an ophthalmologist. The Charlson comorbidity index was used to control for systemic conditions. Cox proportional hazard regression analysis was performed.

RESULTS: OAG occurred in 2.0% (n = 1961) in the HTN group, and 1.7% (n = 1692) in the comparison group (P < 0.001). The OAG incidence rates in patients with and without HTN were 19.0 and 16.4 per 10 000 person-years, respectively. HTN was associated with increased OAG incidence [adjusted hazard ratio (HR) = 1.16, 95% confidence interval: 1.09-1.24] from our multivariate Cox model. Participants with higher SBP (adjusted HR = 1.12 for 120-139 mmHg group; and adjusted HR = 1.20 for ≥140 mmHg group) was more likely to have subsequent OAG compared with participants with less than 120 mmHg blood pressure. Participants with higher DBP (adjusted HR = 1.11 for 80-89 mmHg group: and adjusted HR = 1.07 for ≥90 mmHg group) showed similar trends as participants with less than 80 mmHg blood pressure.

CONCLUSION: Patients diagnosed with HTN are more likely to experience subsequent OAG than those without HTN.