Hypertension, diabetes, and longitudinal changes in intraocular pressure

被引:159
作者
Hennis, A
Wu, SY
Nemesure, B
Leske, MC
机构
[1] SUNY Stony Brook, Med Ctr, Dept Prevent Med, Sch Med, Stony Brook, NY 11794 USA
[2] Univ W Indies, Sch Clin Med & Res, Bridgetown, Barbados
[3] Minist Hlth, Bridgetown, Barbados
[4] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
关键词
D O I
10.1016/S0161-6420(03)00075-7
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: Diabetes and hypertension are recognized risk factors for raised intraocular pressure (IOP). This report examines the longitudinal relationship of hypertension and diabetes to a 4-year IOP change in a black population with high prevalence of these conditions. Design: Population-based cohort study of a simple random sample of residents of Barbados, West Indies, aged greater than or equal to40 years. Participants: A total of 2996 persons without open-angle glaucoma or receiving IOP-lowering medication at baseline. Methods: Participants underwent standardized examinations including applanation tonometry, measurement of blood pressure, and anthropometric indices; a detailed interview; various ocular measurements; and venipuncture for glycosylated hemoglobin (GHb). Diabetes was defined by self-reported physician diagnosis and hypertension by blood pressure greater than or equal to140/90 mmHg and/or treatment history. Main Outcome Measures: The 4-year person-based IOP change between baseline and follow-up was defined as the more positive IOP difference in either eye. Results: An IOP >21 mmHg at baseline was more likely in black and in mixed (black and white) participants (age-gender adjusted odds ratio [OR], 3.9 and 3.8, respectively) than in whites. Similarly, these groups had more hypertension (age-gender adjusted OR, 2.4 and 2.1, respectively) and diabetes (age-gender adjusted OR, 3.9 and 1.7, respectively) than did whites. Mean IOP in black participants increased by 2.5 (standard deviation, 3.9) mmHg over 4 years. Multiple regression analyses showed that baseline diabetes history and hypertension, as well as older age, elevated GHb, higher blood pressures, and lower baseline IOP were associated with a 4-year increase of IOP. The association between diabetes history/GHb and IOP increase became borderline/nonsignificant when persons who underwent cataract surgery during follow-up were excluded. Conclusions: This report provides new data on the relationship of systemic factors to longitudinal increases in IOP in an African-origin population. Results highlight the increased risk of elevated IOP in populations with high prevalences of diabetes and hypertension.
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页码:908 / 914
页数:7
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