Calcium Channel Blocker Use and Glaucoma Study

Calcium channel blocker (CCB) use has been associated with an increased risk of glaucoma in exploratory studies. To examine the association of systemic CCB use with glaucoma and related traits among UK Biobank participants, a population-based cross-sectional study included UK Biobank participants with complete data (2006-2010) for analysis of glaucoma status, intraocular pressure (IOP), and optical coherence tomography (OCT)–derived inner retinal layer thicknesses. Data analysis was conducted in January 2023. Calcium channel blocker use was assessed in a baseline touchscreen questionnaire and confirmed during an interview led by a trained nurse.

Primary Outcome Measures

• Glaucoma status
• Corneal-compensated IOP
• Two OCT-derived inner retinal thickness parameters:
  • Macular retinal nerve fiber layer (mRNFL)
  • Macular ganglion cell–inner plexiform layer (mGCIPL) thicknesses

Authors performed logistic regression and linear regression analyses to test for associations with glaucoma status and IOP and OCT-derived inner retinal thickness parameters, respectively.

Study Participants

This study included 427,480 adults. Their median age was 58 (IQR, 50-63) years, and more than half (54.1%) were women. There were 33,175 CCB users (7.8%). Participants who had complete data for glaucoma status (n = 427,480), IOP (n = 97,100), and OCT-derived inner retinal layer thicknesses (n = 41,023) were eligible for respective analyses.

Study Findings

After adjustment for key sociodemographic, medical, anthropometric, and lifestyle factors, use of CCBs (but not other antihypertensive agents) was associated with greater odds of glaucoma (P = .001). Calcium channel blocker use was also associated with thinner mGCIPL (P = .001) and mRNFL (P = .03) thicknesses but not IOP (P = .84).

In this study, an adverse association between CCB use and glaucoma was observed, with CCB users having, on average, 39% higher odds of glaucoma. Calcium channel blocker use was also associated with thinner mGCIPL and mRNFL thicknesses, providing a structural basis that supports the association with glaucoma. The lack of association of CCB use with IOP suggests that an IOP-independent mechanism of glaucomatous neurodegeneration may be involved. Although a causal relationship has not been established, CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care.

Source

Kastner A, Stuart KV, Montesano G, et al. Calcium Channel Blocker Use and Associated Glaucoma and Related Traits Among UK Biobank Participants. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2023.3877