PMID- 32739337
OWN - NLM
STAT- MEDLINE
DCOM- 20210729
LR  - 20210729
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 128
IP  - 3
DP  - 2021 Mar
TI  - Association of Antihypertensive Medication with Retinal Nerve Fiber Layer and 
      Ganglion Cell-Inner Plexiform Layer Thickness.
PG  - 393-400
LID - S0161-6420(20)30739-9 [pii]
LID - 10.1016/j.ophtha.2020.07.051 [doi]
AB  - PURPOSE: To evaluate the association between different classes of 
      antihypertensive medication with retinal nerve fiber layer (RNFL) and ganglion 
      cell-inner plexiform layer (GC-IPL) thickness in a nonglaucomatous multiethnic 
      Asian population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: 
      A total of 9144 eyes for RNFL analysis (2668 Malays, 3554 Indians, and 2922 
      Chinese) and 8549 eyes for GC-IPL analysis (2460 Malays, 3230 Indians, and 2859 
      Chinese) aged 44 to 86 years. METHODS: Participants underwent standardized 
      systemic and ocular examinations and interviewer-administered questionnaires for 
      collection of data on medication and other variables. Intraocular pressure (IOP) 
      readings were obtained by Goldmann applanation tonometry before pupil dilation 
      for fundoscopy and OCT imaging. Blood pressure (BP) was measured with an 
      automatic BP monitor. Mean arterial pressure (MAP) was defined as diastolic BP 
      plus 1/3 (systolic BP - diastolic BP). Regression models were used to investigate 
      the association of antihypertensive medication with OCT measurements of RNFL and 
      GC-IPL. MAIN OUTCOME MEASURES: Average and sectoral RNFL and GC-IPL thickness. 
      RESULTS: After adjusting for age, gender, ethnicity, MAP, IOP, body mass index 
      (BMI), and presence of diabetes, we found that participants taking any type of 
      antihypertensive medication (beta = -0.83; 95% confidence interval [CI], -1.46 
      to -0.02; P = 0.01), specifically angiotensin-converting enzyme inhibitors 
      (ACEIs) (beta = -1.66; 95% CI, -2.57 to -0.75; P < 0.001) or diuretics (beta = -1.38; 
      95% CI, -2.59 to -0.17; P < 0.05), had thinner average RNFL in comparison with 
      participants who were not receiving antihypertensive treatment. Use of a greater 
      number of antihypertensive medications was significantly associated with thinner 
      average RNFL (P for trend = 0.001). This association was most evident in the 
      inferior RNFL quadrant in participants using ACEIs (beta = -2.44; 95% CI, -3.99 
      to -0.89; P = 0.002) or diuretics (beta = -2.76; 95% CI, -4.76 to -0.76; P = 0.007). 
      A similar trend was noted in our analysis of macular GC-IPL thickness. 
      CONCLUSIONS: Use of 2 or more antihypertensive medications, ACEI, and diuretics 
      were associated with a loss of structural markers of retinal ganglion cell health 
      in a multiethnic Asian population.
CI  - Copyright (c) 2020 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Chong, Rachel S
AU  - Chong RS
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Chee, Miao-Li
AU  - Chee ML
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Tham, Yih-Chung
AU  - Tham YC
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Majithia, Shivani
AU  - Majithia S
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Thakur, Sahil
AU  - Thakur S
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Teo, Zhen Ling
AU  - Teo ZL
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Da Soh, Zhi
AU  - Da Soh Z
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Chua, Jacqueline
AU  - Chua J
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Tan, Bingyao
AU  - Tan B
AD  - Singapore Eye Research Institute, Singapore; SERI-NTU Advanced Ocular Engineering 
      (STANCE), Singapore; NTU Institute of Health Technologies, Singapore.
FAU - Wong, Damon W K
AU  - Wong DWK
AD  - Singapore Eye Research Institute, Singapore; SERI-NTU Advanced Ocular Engineering 
      (STANCE), Singapore; NTU Institute of Health Technologies, Singapore.
FAU - Schmetterer, Leopold
AU  - Schmetterer L
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore; SERI-NTU Advanced Ocular 
      Engineering (STANCE), Singapore; NTU Institute of Health Technologies, Singapore; 
      School of Chemical and Biomedical Engineering, Nanyang Technological University, 
      Singapore; Department of Clinical Pharmacology, Medical University of Vienna, 
      Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical 
      University of Vienna, Vienna, Austria; Institute of Molecular and Clinical 
      Ophthalmology, Basel, Switzerland.
FAU - Sabanayagam, Charumathi
AU  - Sabanayagam C
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore.
FAU - Cheng, Ching-Yu
AU  - Cheng CY
AD  - Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, 
      Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), 
      Duke-NUS Medical School Singapore, Singapore. Electronic address: 
      chingyu.cheng@duke-nus.edu.sg.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200731
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Diuretics)
SB  - IM
CIN - Ophthalmology. 2021 Mar;128(3):401-402. PMID: 33612165
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin-Converting Enzyme Inhibitors/*adverse effects
MH  - Antihypertensive Agents/*adverse effects
MH  - Arterial Pressure/drug effects
MH  - Blood Pressure/drug effects
MH  - Cross-Sectional Studies
MH  - Diuretics/*adverse effects
MH  - Female
MH  - Humans
MH  - Intraocular Pressure
MH  - Male
MH  - Middle Aged
MH  - Nerve Fibers/*drug effects/pathology
MH  - Retinal Diseases/*chemically induced/diagnosis
MH  - Retinal Ganglion Cells/*drug effects/pathology
MH  - Retinal Neurons/*drug effects/pathology
MH  - Surveys and Questionnaires
MH  - Tomography, Optical Coherence
MH  - Tonometry, Ocular
OTO - NOTNLM
OT  - GC-IPL
OT  - OCT
OT  - RNFL
OT  - anti-hypertensive
OT  - glaucoma
OT  - hypertension
OT  - medication
OT  - systemic medication
EDAT- 2020/08/03 06:00
MHDA- 2021/07/30 06:00
CRDT- 2020/08/03 06:00
PHST- 2020/03/24 00:00 [received]
PHST- 2020/07/23 00:00 [revised]
PHST- 2020/07/27 00:00 [accepted]
PHST- 2020/08/03 06:00 [pubmed]
PHST- 2021/07/30 06:00 [medline]
PHST- 2020/08/03 06:00 [entrez]
AID - S0161-6420(20)30739-9 [pii]
AID - 10.1016/j.ophtha.2020.07.051 [doi]
PST - ppublish
SO  - Ophthalmology. 2021 Mar;128(3):393-400. doi: 10.1016/j.ophtha.2020.07.051. Epub 
      2020 Jul 31.