Institutional members access full text with Ovid®

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

Rim, Tyler H.; Lee, Sang Y.; Kim, Seo H.; Kim, Sung S.; Kim, Chan Y.

doi: 10.1097/HJH.0000000000001225
ORIGINAL PAPERS: Epidemiology

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.

aDepartment of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul

bDepartment of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang

cKong Eye Center

dYonsei Healthcare Big Data-Based Knowledge Integration System Research Center, Yonsei University College of Medicine

eInstitute of Convergence Science, Yonsei University College of Medicine, Seoul, South Korea

Correspondence to Sung S. Kim, MD, PhD, Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. Tel: +82 10 2191 6313; fax: +82 2 312 0541; e-mail: semekim@yuhs.ac; Chan Y. Kim, MD, PhD, Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. Tel: +82 2 2228 3570; fax: +82 2 312 0541; e-mail: kcyeye@yuhs.ac

Abbreviations: CI, confidence interval; HR, hazard ratio; KCD, Korean Classification of Diseases; KEDI, Korean electronic data interchange; KNHIS, Korea National Health Insurance Service; NHIS-NSC 2002–2013, National Health Insurance Service National Sample Cohort 2002–2013; OAG, open-angle glaucoma

Received 2 February, 2016

Revised 1 October, 2016

Accepted 28 November, 2016

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.