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Ophthalmology. 2003 May;110(5):908-14.

Hypertension, diabetes, and longitudinal changes in intraocular pressure.

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School of Clinical Medicine & Research, University of the West Indies, Barbados, West Indies.



Diabetes and hypertension are recognized risk factors for raised intraocular pressure (IOP). This report examines the longitudinal relationship of hypertension and diabetes to a 4-year IOP change in a black population with high prevalence of these conditions.


Population-based cohort study of a simple random sample of residents of Barbados, West Indies, aged >/=40 years.


A total of 2996 persons without open-angle glaucoma or receiving IOP-lowering medication at baseline.


Participants underwent standardized examinations including applanation tonometry, measurement of blood pressure, and anthropometric indices; a detailed interview; various ocular measurements; and venipuncture for glycosylated hemoglobin (GHb). Diabetes was defined by self-reported physician diagnosis and hypertension by blood pressure >/=140/90 mmHg and/or treatment history.


The 4-year person-based IOP change between baseline and follow-up was defined as the more positive IOP difference in either eye.


An IOP >21 mmHg at baseline was more likely in black and in mixed (black and white) participants (age-gender adjusted odds ratio [OR], 3.9 and 3.8, respectively) than in whites. Similarly, these groups had more hypertension (age-gender adjusted OR, 2.4 and 2.1, respectively) and diabetes (age-gender adjusted OR, 3.9 and 1.7, respectively) than did whites. Mean IOP in black participants increased by 2.5 (standard deviation, 3.9) mmHg over 4 years. Multiple regression analyses showed that baseline diabetes history and hypertension, as well as older age, elevated GHb, higher blood pressures, and lower baseline IOP were associated with a 4-year increase of IOP. The association between diabetes history/GHb and IOP increase became borderline/nonsignificant when persons who underwent cataract surgery during follow-up were excluded.


This report provides new data on the relationship of systemic factors to longitudinal increases in IOP in an African-origin population. Results highlight the increased risk of elevated IOP in populations with high prevalences of diabetes and hypertension.

[Indexed for MEDLINE]

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