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Hypertension associated with increased IOP, POAG, analysis shows
A recent American Journal of Ophthalmology review and meta-analysis demonstrated a need to manage hypertension in primary open-angle glaucoma patients.
Zhao and colleagues also recommended that patients with hypertension be screened for indicators of glaucoma.
Researchers reviewed 60 studies from the EMBASE and PubMed databases to analyze risks and differences throughout the studies, as detailed in the analysis.
Results showed that the risk for POAG was higher in those with hypertension; the researchers reported that patients with hypertension were 1.16 times more likely to develop POAG.
"Virtually all studies reported a positive association between blood pressure and intraocular pressure," the authors also noted.
"In spite of methodological heterogeneity across studies, we identified a consistent and robust association between blood pressure and IOP," the authors concluded. "This association was evident across different populations, study designs and publication periods. We also identified a significant association between hypertension and POAG, although there was significant heterogeneity across study designs. Additional prospective studies are needed to firmly establish the role of blood pressure in glaucoma development. Our analysis supports that hypertensive patients should be screened for elevated IOP and higher risk for POAG, and that hypertension management be included as part of POAG treatment regimes."
Perspective
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“Is my high eye pressure related to high blood pressure?” I hear this question in clinic daily, and typically answer that it might be a minor factor contributing to elevated eye pressure and glaucoma.
Zhao and associates have impressively combined the results of many studies in order to addresses this complex question. In their meta-analysis of 60 papers they found a strong positive association between intraocular pressure and blood pressure with a 10 mm Hg elevation in systolic blood pressure associated with a modest 0.26 mm Hg average elevation in IOP. Also, they discovered a slightly higher risk of primary open-angle glaucoma (POAG) in patients with hypertension (1.16 times), although this was a weaker association.
These modest associations are interesting, but do not change our clinical approach. Elevated blood pressure remains a soft association that does not play a significant role in POAG risk assessment.