A new study emphasizes the importance of controlling hypertension early in diabetes, even before the onset of diabetic retinopathy. Photo: British Heart Foundation. 

Calcium channel blockers (CCB) are commonly prescribed to treat hypertension, but the literature suggests that these drugs may increase the risk of primary open-angle glaucoma (POAG). Since both of these often comorbid conditions are highly prevalent in Black populations, researchers turned to the NIH All of Us dataset, a cohort known for its demographic, geographic and medical diversity as well as its inclusion of historically underrepresented groups. They found that certain CCBs are associated with a significantly higher risk of developing POAG.

The retrospective study included 213,424 participants 40 years of age or older with no prior POAG diagnosis. In the cohort, 1.3% of patients were diagnosed with POAG and 98.7% were not. In the POAG group, the mean patient age was 73 years, 52.5% were female and 48.2% were white.

The researchers reported that among those who developed POAG, 32.6% used one or more CCBs, 28.2% used a dihydropyridine CCB and 2.2% used a non-dihydropyridine CCB. Bivariate analysis and multivariate adjusted analysis both showed use of any CCB was associated with increased risk of POAG. In particular, the use of dihydropyridine CCBs was associated with increased risk of POAG.

The researchers wrote in their Ophthalmology Glaucoma paper that relationship between CCBs and ocular health is complex, but that use of these commonly prescribed anti-hypertensives may be associated with glaucoma. “A growing evidence base is needed to better understand how to balance treatment needs for glaucoma and hypertension, particularly in an aging population with growing prevalence and public health burden of both conditions,” the researchers concluded.

Tavakoli K, Sidhu S, Saseendrakumar BR, et al. Long term systemic use of calcium channel blockers and incidence of primary open angle glaucoma. Ophthalmology Glaucoma 2024. [Epub ahead of print].