作者
Alan Kastner,Kelsey V. Stuart,Giovanni Montesano,Carlos Gustavo De Moraes,Jae H. Kang,Janey L. Wiggs,Louis R. Pasquale,Pirro G. Hysi,Sharon Chua,Praveen J. Patel,Paul J. Foster,Peng T. Khaw,Anthony P. Khawaja,Naomi E. Allen,Tariq Aslam,Denize Atan,Konstantinos Balaskas,Sarah Barman,Jenny Barrett,Paul Bishop,Graeme Black,Tasanee Braithwaite,Roxana O. Carare,Usha Chakravarthy,Michelle Chan,Sharon Chua,Alexander Day,Parul Desai,Bal Dhillon,Andrew D. Dick,Alexander Doney,Cathy Egan,Sarah Ennis,Paul J. Foster,Marcus Fruttiger,John Gallacher,David Garway-Heath,Jane Gibson,Jeremy A. Guggenheim,Chris Hammond,Alison J Hardcastle,Simon Harding,Ruth Hogg,Pirro G. Hysi,Pearse Andrew Keane,Peng Tee Khaw,Anthony P. Khawaja,Gerassimos Lascaratos,Thomas J Littlejohns,Andrew Lotery,Robert Luben,Philip J. Luthert,Tom MacGillivray,Michael McDermott,Savita Madhusudhan,Bernadette McGuinness,Gareth McKay,Martin McKibbin,Tony Moore,James E. Morgan,Eoin O’Sullivan,Richard A. Oram,Chris Owen,Praveen J. Patel,Euan Paterson,Tünde Pető,Axel Petzold,Nikolas Pontikos,Jugnoo S. Rahi,Alicja Rudnicka,Naveed Sattar,Jay Self,Panagiotis I. Sergouniotis,Sobha Sivaprasad,David Steel,Irene Stratton,Nicholas G. Strouthidis,Cathie Sudlow,Zihan Sun,Robyn J. Tapp,Dhanes Thomas,Emanuele Trucco,Adnan Tufail,Ananth C. Viswanathan,Véronique Vitart,Michael N. Weedon,Katie Williams,Cathy Williams,J Woodside,Max Yates,Yalin Zheng
摘要
Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies.To examine the association of systemic CCB use with glaucoma and related traits among UK Biobank 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.Calcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse.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.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).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.