Low BP ups risk of open-angle glaucoma

Low levels of blood pressure (BP) appear to elevate the risk of developing open-angle glaucoma (OAG), reveals a recent US study. In addition, there is no evidence supporting a differential effect of medically treated and untreated low BP.

This retrospective, longitudinal cohort study used a national electronic health record (HER) database administered by the National Institutes of Health. Eye patients in the All of Us Research Program database with at least 15 months of follow-up and one BP measurement were included.

The authors used univariable and multivariable Cox regression models to predict the risk of developing incident OAG. They accounted for changes over time by entering mean arterial pressure (MAP) and the number of BP medication classes as time-varying predictors.

A total of 20,815 eligible eye patients were eligible for analysis, of whom 462 developed OAG. Low BP (MAP <83.0 mm Hg) correlated with a higher risk of developing OAG (hazard ratio [HR], 1.32, 95 percent confidence interval [CI], 1.04‒1.67), while high BP (MAP >101.3 mm Hg) and the number of BP drug classes did not after adjustment for covariates.

Other risk factors correlating with OAG development were being Black (HR, 3.31, 95 percent CI, 2.63‒4.17), Hispanic or Latino (HR, 2.53, 95 percent CI, 1.94‒3.28), Asian (HR, 2.22, 95 percent CI, 1.24‒3.97), older in age (>80 years; HR, 20.1, 95 percent CI, 9.10‒44.5), and diabetic (HR, 1.32, 95 percent CI, 1.04‒1.67). Female gender, however, was associated with a lower OAG risk (HR, 0.66, 95 percent CI, 0.55‒0.80).

Of note, MAP and the number of BP medications showed no significant association with the risk of developing OAG.

“This study adds to the body of literature implicating vascular dysregulation as a potential aetiology for the development of OAG, particularly emphasizing the lack of influence of BP medications on this relationship,” the authors said.