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Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study

PURPOSE: To examine the risk of open-angle glaucoma (OAG) among patients receiving alpha1-adrenoceptor (α1-AR) antagonists for lower urinary tract symptoms (LUTS). METHODS: This was a nationwide, population-based, retrospective cohort study from Asia/Taiwan. One million beneficiaries were randomly s...

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Autores principales: Lin, Hong-Zin, Hsieh, Tsung-Cheng, Wu, Jung-Lun, He, Ming-Shan, Lee, Yuan-Chieh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441300/
https://www.ncbi.nlm.nih.gov/pubmed/32766746
http://dx.doi.org/10.1167/iovs.61.10.15
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author Lin, Hong-Zin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
He, Ming-Shan
Lee, Yuan-Chieh
author_facet Lin, Hong-Zin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
He, Ming-Shan
Lee, Yuan-Chieh
author_sort Lin, Hong-Zin
collection PubMed
description PURPOSE: To examine the risk of open-angle glaucoma (OAG) among patients receiving alpha1-adrenoceptor (α1-AR) antagonists for lower urinary tract symptoms (LUTS). METHODS: This was a nationwide, population-based, retrospective cohort study from Asia/Taiwan. One million beneficiaries were randomly sampled from among 27.38 million individuals enrolled in the National Health Insurance program, and subjects with a diagnosis of LUTS from 2001 to 2012 were identified (N = 105,341). After 1:1 propensity score matching by gender, age, comorbid medical diseases, number of all medical visits during the observational period, and index date, 4081 patients were enrolled in the study group, comprised of patients who had taken α1-AR antagonists, and 4081 patients were enrolled in the control group, comprised of patients who had never taken α1-AR antagonists. The incidence and risk of OAG (defined as two ambulatory visits with a ICD-9 diagnosis code 365, excluding ICD-9 diagnosis codes 365.2–365.6, 365.02, 365.03, 365.13, 365.14, and 365.8) were calculated. RESULTS: Patients taking α1-AR antagonists had a higher incidence ratio of 1.86 (95% confidence interval [CI], 1.30–2.65) for developing OAG. After adjusting for age, gender, and comorbidities, the hazard ratio (HR) for OAG for patients taking α1-AR antagonists was 1.66 (95% CI, 1.16–2.39; P = 0.006). Among patients with hypertension, the hazard ratio for OAG associated with taking α1-AR antagonists increased to 1.79 (95% CI, 1.07–2.99; P = 0.003). On the other hand, the association of α1-AR antagonists with OAG was not significant among patients with diabetes mellitus, hyperlipidemia, or older age. CONCLUSIONS: The findings of our study suggest an increased risk for OAG among patients taking α1-AR antagonists for LUTS, especially in patients with hypertension.
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spelling pubmed-74413002020-08-31 Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study Lin, Hong-Zin Hsieh, Tsung-Cheng Wu, Jung-Lun He, Ming-Shan Lee, Yuan-Chieh Invest Ophthalmol Vis Sci Glaucoma PURPOSE: To examine the risk of open-angle glaucoma (OAG) among patients receiving alpha1-adrenoceptor (α1-AR) antagonists for lower urinary tract symptoms (LUTS). METHODS: This was a nationwide, population-based, retrospective cohort study from Asia/Taiwan. One million beneficiaries were randomly sampled from among 27.38 million individuals enrolled in the National Health Insurance program, and subjects with a diagnosis of LUTS from 2001 to 2012 were identified (N = 105,341). After 1:1 propensity score matching by gender, age, comorbid medical diseases, number of all medical visits during the observational period, and index date, 4081 patients were enrolled in the study group, comprised of patients who had taken α1-AR antagonists, and 4081 patients were enrolled in the control group, comprised of patients who had never taken α1-AR antagonists. The incidence and risk of OAG (defined as two ambulatory visits with a ICD-9 diagnosis code 365, excluding ICD-9 diagnosis codes 365.2–365.6, 365.02, 365.03, 365.13, 365.14, and 365.8) were calculated. RESULTS: Patients taking α1-AR antagonists had a higher incidence ratio of 1.86 (95% confidence interval [CI], 1.30–2.65) for developing OAG. After adjusting for age, gender, and comorbidities, the hazard ratio (HR) for OAG for patients taking α1-AR antagonists was 1.66 (95% CI, 1.16–2.39; P = 0.006). Among patients with hypertension, the hazard ratio for OAG associated with taking α1-AR antagonists increased to 1.79 (95% CI, 1.07–2.99; P = 0.003). On the other hand, the association of α1-AR antagonists with OAG was not significant among patients with diabetes mellitus, hyperlipidemia, or older age. CONCLUSIONS: The findings of our study suggest an increased risk for OAG among patients taking α1-AR antagonists for LUTS, especially in patients with hypertension. The Association for Research in Vision and Ophthalmology 2020-08-07 /pmc/articles/PMC7441300/ /pubmed/32766746 http://dx.doi.org/10.1167/iovs.61.10.15 Text en Copyright 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Glaucoma
Lin, Hong-Zin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
He, Ming-Shan
Lee, Yuan-Chieh
Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title_full Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title_fullStr Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title_full_unstemmed Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title_short Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study
title_sort systemic alpha1-adrenoceptor antagonists and increased risk of open-angle glaucoma: a nationwide population-based cohort study
topic Glaucoma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441300/
https://www.ncbi.nlm.nih.gov/pubmed/32766746
http://dx.doi.org/10.1167/iovs.61.10.15
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