Systemic antihypertensive medication and incident open-angle glaucoma

Purpose: To determine the association between systemic anti hypertensive medication and incident open-angle glaucoma.Design: Prospective population-based cohort study.Participants: The study population consisted of a subset of 3842 participants of the Rotterdam Study for whom data from identical ophthalmologic examinations at baseline and follow-up were available.Methods: Use of anti hypertensive medication was registered over an average follow-up period of 6.5 years. Associations between incident open-angle glaucoma and anti hypertensive medication were assessed using multivariate logistic regression models adjusted for age, gender, duration of follow-up, intraocular pressure, intraocular pressure-lowering medication, and cardiovascular disease.Main Outcome Measures: Odds ratios of associations between incident open-angle glaucoma and use of anti hypertensive medication.Results: During follow-up, there were 87 incident cases of open-angle glaucoma. Participants using calcium channel antagonists had a 1.8-fold (95% confidence interval [Cl], 1.04-3.2; P = 0.037) higher risk of developing incident open-angle glaucoma. beta-Blockers were associated with a nonsignificant risk reduction (odds ratio, 0.6; 95% Cl, 0.3-1.02; P = 0.060). None of the other classes of anti hypertensives was significantly associated with incident open-angle glaucoma.Conclusions: These data suggest that use of calcium channel antagonists is associated with open-angle glaucoma, but this requires confirmation. These results do not support the use of calcium channel antagonists for the treatment of normal-tension glaucoma.