长期系统使用钙通道阻滞剂与原发性开角型青光眼的发病率。

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2024-09-01 DOI:10.1016/j.ogla.2024.06.003

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引用次数: 0

摘要

目的：利用一个多样化的全国性数据集，评估全身使用钙通道阻滞剂（CCBs）与原发性开角型青光眼（POAG）之间的关联：对象：美国国立卫生研究院（NIH）"我们所有人 "数据集中的 213,424 名 40 岁及以上的患者。在使用任何类型的抗高血压药物之前诊断出 POAG 的患者不包括在内：进行二元和多元回归分析，以评估CCB的使用与POAG之间的关联。将CCB的使用进一步分为接触二氢吡啶类CCB和非二氢吡啶类CCB，并使用Chi-square和Fisher检验进行亚组分析：结果：在我们的队列中，2772 名参与者（1.3%）被诊断为 POAG，210652 名参与者（98.7%）未被诊断为 POAG。在确诊为 POAG 的患者中，平均年龄为 73.3 岁，52.5% 为女性，48.2% 为白人。在 POAG 患者中，32.6% 使用了一种或多种 CCB，28.2% 使用了二氢吡啶类 CCB，2.2% 使用了非二氢吡啶类 CCB。在双变量分析中，使用任何一种CCB都与POAG风险增加有关（OR：1.29，95% CI：1.27-1.31，p结论：使用二氢吡啶类钙通道阻滞剂与罹患 POAG 的风险显著升高有关，无论是在调整人口统计学因素和合并症之前还是之后。

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Long-Term Systemic Use of Calcium Channel Blockers and Incidence of Primary Open-Angle Glaucoma

Purpose

To evaluate the association between the systemic use of calcium channel blockers (CCBs) and primary open-angle glaucoma (POAG) using a diverse nationwide dataset.

Design

Retrospective cohort study.

Subjects

213 424 individuals aged 40 years and older in the National Institutes of Health All of Us dataset, notable for its demographic, geographic, and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of antihypertensive medication were excluded.

Methods

Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. Calcium channel blocker use was further divided into exposure to dihydropyridine CCBs and nondihydropyridine CCBs, and subgroup analyses were performed using chi-square and Fisher tests.

Main Outcome Measures

Diagnosis of POAG.

Results

Within our cohort, 2772 participants (1.3%) acquired a diagnosis of POAG, while 210 652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among patients with POAG, 32.6% used 1 or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a nondihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.27–1.31, P < 0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33–1.74, P < 0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14–1.50, P < 0.001) was associated with increased POAG risk.

Conclusions

Use of dihydropyridine CCBs was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions.