Calcium Channel Blocker Use and Associated Glaucoma and Related Traits Among UK Biobank Participants
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Published:2023-10-01
Issue:10
Volume:141
Page:956
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ISSN:2168-6165
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Container-title:JAMA Ophthalmology
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language:en
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Short-container-title:JAMA Ophthalmol
Author:
Kastner Alan12, Stuart Kelsey V.1, Montesano Giovanni13, De Moraes C. Gustavo4, Kang Jae H.5, Wiggs Janey L.6, Pasquale Louis R.7, Hysi Pirro89, Chua Sharon Y. L.1, Patel Praveen J.1, Foster Paul J.1, Khaw Peng T.1, Khawaja Anthony P.1, Allen Naomi10, Aslam Tariq10, Atan Denize10, Balaskas Konstantinos10, Barman Sarah10, Barrett Jenny10, Bishop Paul10, Black Graeme10, Braithwaite Tasanee10, Carare Roxana10, Chakravarthy Usha10, Chan Michelle10, Chua Sharon10, Day Alexander10, Desai Parul10, Dhillon Bal10, Dick Andrew10, Doney Alexander10, Egan Cathy10, Ennis Sarah10, Foster Paul10, Fruttiger Marcus10, Gallacher John10, Garway-Heath David10, Gibson Jane10, Guggenheim Jeremy10, Hammond Chris10, Hardcastle Alison10, Harding Simon10, Hogg Ruth10, Hysi Pirro10, Keane Pearse10, Khaw Peng10, Khawaja Anthony10, Lascaratos Gerassimos10, Littlejohns Thomas10, Lotery Andrew10, Luben Robert10, Luthert Phil10, MacGillivray Tom10, Mackie Sarah10, Madhusudhan Savita10, McGuinness Bernadette10, McKay Gareth10, McKibbin Martin10, Moore Tony10, Morgan James10, O'Sullivan Eoin10, Oram Richard10, Owen Chris10, Patel Praveen10, Paterson Euan10, Peto Tunde10, Petzold Axel10, Pontikos Nikolas10, Rahi Jugnoo10, Rudnicka Alicja10, Sattar Naveed10, Self Jay10, Sergouniotis Panagiotis10, Sivaprasad Sobha10, Steel David10, Stratton Irene10, Strouthidis Nicholas10, Sudlow Cathie10, Sun Zihan10, Tapp Robyn10, Thomas Dhanes10, Trucco Emanuele10, Tufail Adnan10, Viswanathan Ananth10, Vitart Veronique10, Weedon Mike10, Williams Katie10, Williams Cathy10, Woodside Jayne10, Yates Max10, Zheng Yalin10,
Affiliation:
1. National Institute for Health and Care Research Biomedical Research Centre, Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom 2. Clínica Oftalmológica Pasteur, Santiago, Chile 3. Division of Optometry and Vision Science, City University of London, London, United Kingdom 4. Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York 5. Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 6. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts 7. Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York 8. Department of Ophthalmology, King’s College London, St Thomas’ Hospital, London, United Kingdom 9. Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, London, United Kingdom 10. for the UK Biobank Eye and Vision Consortium
Abstract
ImportanceCalcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies.ObjectiveTo examine the association of systemic CCB use with glaucoma and related traits among UK Biobank participants.Design, Setting, and ParticipantsThis population-based cross-sectional study included UK Biobank participants with complete data (2006-2010) for analysis of glaucoma status, intraocular pressure (IOP), and optical coherence tomography (OCT)–derived inner retinal layer thicknesses. Data analysis was conducted in January 2023.ExposureCalcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse.Main Outcomes and MeasuresThe primary outcome measures included glaucoma status, corneal-compensated IOP, and 2 OCT-derived inner retinal thickness parameters (macular retinal nerve fiber layer [mRNFL] and macular ganglion cell–inner plexiform layer [mGCIPL] thicknesses). We performed logistic regression and linear regression analyses to test for associations with glaucoma status and IOP and OCT-derived inner retinal thickness parameters, respectively.ResultsThis study included 427 480 adults. Their median age was 58 (IQR, 50-63) years, and more than half (54.1%) were women. There were 33 175 CCB users (7.8%). Participants who had complete data for glaucoma status (n = 427 480), IOP (n = 97 100), and OCT-derived inner retinal layer thicknesses (n = 41 023) were eligible for respective analyses. After adjustment for key sociodemographic, medical, anthropometric, and lifestyle factors, use of CCBs (but not other antihypertensive agents) was associated with greater odds of glaucoma (odds ratio [OR], 1.39 [95% CI, 1.14 to 1.69]; P = .001). Calcium channel blocker use was also associated with thinner mGCIPL (−0.34 μm [95% CI, −0.54 to −0.15 μm]; P = .001) and mRNFL (−0.16 μm [95% CI, −0.30 to −0.02 μm]; P = .03) thicknesses but not IOP (−0.01 mm Hg [95% CI, −0.09 to 0.07 mm Hg]; P = .84).Conclusions and RelevanceIn this study, an adverse association between CCB use and glaucoma was observed, with CCB users having, on average, 39% higher odds of glaucoma. Calcium channel blocker use was also associated with thinner mGCIPL and mRNFL thicknesses, providing a structural basis that supports the association with glaucoma. The lack of association of CCB use with IOP suggests that an IOP-independent mechanism of glaucomatous neurodegeneration may be involved. Although a causal relationship has not been established, CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care.
Publisher
American Medical Association (AMA)
Cited by
3 articles.
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