| Title: | Calcium Channel Blocker Use and Associated Glaucoma and Related Traits Among UK Biobank Participants |
| Journal: | JAMA Ophthalmology |
| Published: | 1 Oct 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/37676684/ |
| DOI: | https://doi.org/10.1001/jamaophthalmol.2023.3877 |
Publication 9437
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Abstract
Importance: Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies.</p>
Objective: To examine the association of systemic CCB use with glaucoma and related traits among UK Biobank participants.</p>
Design, Setting, and Participants: This 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.</p>
Exposure: Calcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse.</p>
Main Outcomes and Measures: The 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.</p>
Results: This 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).</p>
Conclusions and Relevance: In 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.</p>
91 Authors
- Alan Kastner
- Kelsey V. Stuart
- Giovanni Montesano
- C. Gustavo De Moraes
- Jae H. Kang
- Janey L. Wiggs
- Louis R. Pasquale
- Pirro Hysi
- Sharon Y. L. Chua
- Praveen J. Patel
- Paul J. Foster
- Peng T. Khaw
- Anthony P. Khawaja
- Naomi Allen
- Tariq Aslam
- Denize Atan
- Konstantinos Balaskas
- Sarah Barman
- Jenny Barrett
- Paul Bishop
- Graeme Black
- Tasanee Braithwaite
- Roxana Carare
- Usha Chakravarthy
- Michelle Chan
- Sharon Chua
- Alexander Day
- Parul Desai
- Bal Dhillon
- Andrew Dick
- Alexander Doney
- Cathy Egan
- Sarah Ennis
- Paul Foster
- Marcus Fruttiger
- John Gallacher
- David Garway-Heath
- Jane Gibson
- Jeremy Guggenheim
- Chris Hammond
- Alison Hardcastle
- Simon Harding
- Ruth Hogg
- Pirro Hysi
- Pearse Keane
- Peng Khaw
- Anthony Khawaja
- Gerassimos Lascaratos
- Thomas Littlejohns
- Andrew Lotery
- Robert Luben
- Phil Luthert
- Tom MacGillivray
- Sarah Mackie
- Savita Madhusudhan
- Bernadette McGuinness
- Gareth McKay
- Martin McKibbin
- Tony Moore
- James Morgan
- Eoin O'Sullivan
- Richard Oram
- Chris Owen
- Praveen Patel
- Euan Paterson
- Tunde Peto
- Axel Petzold
- Nikolas Pontikos
- Jugnoo Rahi
- Alicja Rudnicka
- Naveed Sattar
- Jay Self
- Panagiotis Sergouniotis
- Sobha Sivaprasad
- David Steel
- Irene Stratton
- Nicholas Strouthidis
- Cathie Sudlow
- Zihan Sun
- Robyn Tapp
- Dhanes Thomas
- Emanuele Trucco
- Adnan Tufail
- Ananth Viswanathan
- Veronique Vitart
- Mike Weedon
- Katie Williams
- Cathy Williams
- Jayne Woodside
- Max Yates
- Yalin Zheng
1 Application
| Application ID | Title |
|---|---|
| 36741 | Discovering the biological mechanisms underlying glaucoma and neurodegeneration by analysis of genetic and environmental determinants and associations with other systemic traits in the UK Biobank |
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