Vascular risk factors for primary open angle glaucoma - The Egna-Neumarkt study

Objective: To assess the impact of vascular risk factors on the prevalence of primary open angle glaucoma. Design: Population-based cross-sectional study. Participants: Four thousand two hundred ninety-seven patients more than 40 years of age underwent a complete ocular examination in the context of the Egna-Neumarkt Glaucoma Study. Intervention: Ocular examinations were performed by trained, quality-contro lled ophthalmologists according to a predefined standardized protocol inclu ding medical interview, blood pressure reading, applanation tonometry, comp uterized perimetry, and optic nerve head examination, Main Outcome Measures : Prevalences of ocular hypertension, primary open-angle glaucoma, normal-t ension glaucoma, and other types of glaucoma were determined. Correlation c oefficients were calculated for the association between systemic blood pres sure and age-adjusted intraocular pressure (IOP) and between age and both i ntraocular and systemic blood pressures. Odds ratios were computed to asses s the risk of primary open-angle glaucoma and normal-tension glaucoma in re lation to systemic hypertension or antihypertensive medication, blood press ure levels, diastolic perfusion pressure, and a number of other cardiovascu lar risk factors. Results: A positive correlation was found between systemic blood pressure a nd IOP, and an association was found between diagnosis of primary open-angl e glaucoma and systemic hypertension. Lower diastolic perfusion pressure is associated with a marked, progressive increase in the frequency of hyperte nsive glaucoma. No relationship was found between systemic diseases of vasc ular origin and glaucoma. Conclusions: Our data are in line with those reported in other recent epide miologic studies and show that reduced diastolic perfusion pressure is an i mportant risk factor for primary open-angle glaucoma, (C) 2000 by the Ameri can Academy of Ophthalmology.