Abstract：
OBJECTIVE: To evaluate the association between the systemic use of calcium channel blockers (CCBs) and primary open-angle glaucoma (POAG) using a diverse nationwide dataset.
METHODS: Retrospective cohort study SUBJECTS: 213,424 individuals aged 40 years and older in the National Institutes of Health (NIH) All of Us dataset, notable for its demographic, geographic and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of anti-hypertensive medication were excluded.
METHODS: Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. CCB use was further divided into exposure to dihydropyridine CCBs and non-dihydropyridine CCBs, and subgroup analyses were performed using Chi-square and Fisher\'s tests.
METHODS: Diagnosis of POAG RESULTS: Within our cohort, 2,772 participants (1.3%) acquired a diagnosis of POAG, while 210,652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among POAG patients, 32.6% used one or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a non-dihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (OR: 1.29, 95% CI: 1.27-1.31, p<0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33-1.74, p<0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14-1.50, p<0.001) was associated with increased POAG risk.
CONCLUSIONS: Use of dihydropyridine calcium channel blockers was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions.
METHODS: Retrospective cohort study SUBJECTS: 213,424 individuals aged 40 years and older in the National Institutes of Health (NIH) All of Us dataset, notable for its demographic, geographic and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of anti-hypertensive medication were excluded.
METHODS: Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. CCB use was further divided into exposure to dihydropyridine CCBs and non-dihydropyridine CCBs, and subgroup analyses were performed using Chi-square and Fisher\'s tests.
METHODS: Diagnosis of POAG RESULTS: Within our cohort, 2,772 participants (1.3%) acquired a diagnosis of POAG, while 210,652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among POAG patients, 32.6% used one or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a non-dihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (OR: 1.29, 95% CI: 1.27-1.31, p<0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33-1.74, p<0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14-1.50, p<0.001) was associated with increased POAG risk.
CONCLUSIONS: Use of dihydropyridine calcium channel blockers was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions.
摘要：
目的：使用不同的全国性数据集评估全身使用钙通道阻滞剂（CCB）与原发性开角型青光眼（POAG）之间的关联。
方法：回顾性队列研究受试者：美国国立卫生研究院（NIH）中213,424名40岁及以上的个体，值得注意的是它的人口统计，地理和医疗多样性以及历史上代表性不足的人群的包容性。排除在使用任何类型的抗高血压药物之前诊断为POAG的患者。
方法：进行双变量和多变量回归分析以评估CCB使用与POAG之间的关联。CCB的使用进一步分为暴露于二氢吡啶CCB和非二氢吡啶CCB，亚组分析采用卡方检验和Fisher检验进行。
方法：POAG结果的诊断：在我们的队列中，2772名参与者（1.3%）诊断为POAG，而210,652（98.7%）没有。在患有POAG的患者中，平均年龄为73.3岁,52.5%是女性，和48.2％确定为白色。在POAG患者中，32.6%使用一个或多个CCB，28.2%使用了二氢吡啶CCB，2.2%使用非二氢吡啶CCB。在双变量分析中，任何CCB的使用均与POAG风险增加相关(OR:1.29,95%CI:1.27-1.31,p<0.001).在调整年龄的多变量分析中，性别,种族,种族,和糖尿病等合并症，高脂血症,和高血压，任何CCB的使用仍然与POAG的风险增加相关(OR:1.52,95%CI:1.33-1.74,p<0.001).按CCB类型分层时，使用二氢吡啶类CCBs(OR:1.31,95%CI:1.14~1.50,p<0.001)与POAG风险增加相关.
结论：使用二氢吡啶类钙通道阻滞剂与发生POAG的风险显著增高相关，在调整人口因素和合并症的医疗条件之前和期间。
方法：回顾性队列研究受试者：美国国立卫生研究院（NIH）中213,424名40岁及以上的个体，值得注意的是它的人口统计，地理和医疗多样性以及历史上代表性不足的人群的包容性。排除在使用任何类型的抗高血压药物之前诊断为POAG的患者。
方法：进行双变量和多变量回归分析以评估CCB使用与POAG之间的关联。CCB的使用进一步分为暴露于二氢吡啶CCB和非二氢吡啶CCB，亚组分析采用卡方检验和Fisher检验进行。
方法：POAG结果的诊断：在我们的队列中，2772名参与者（1.3%）诊断为POAG，而210,652（98.7%）没有。在患有POAG的患者中，平均年龄为73.3岁,52.5%是女性，和48.2％确定为白色。在POAG患者中，32.6%使用一个或多个CCB，28.2%使用了二氢吡啶CCB，2.2%使用非二氢吡啶CCB。在双变量分析中，任何CCB的使用均与POAG风险增加相关(OR:1.29,95%CI:1.27-1.31,p<0.001).在调整年龄的多变量分析中，性别,种族,种族,和糖尿病等合并症，高脂血症,和高血压，任何CCB的使用仍然与POAG的风险增加相关(OR:1.52,95%CI:1.33-1.74,p<0.001).按CCB类型分层时，使用二氢吡啶类CCBs(OR:1.31,95%CI:1.14~1.50,p<0.001)与POAG风险增加相关.
结论：使用二氢吡啶类钙通道阻滞剂与发生POAG的风险显著增高相关，在调整人口因素和合并症的医疗条件之前和期间。
