A common type of medicine used to treat high blood pressure may be linked to a greater risk of glaucoma, according to a large UK study.
The medicines, known as calcium channel blockers, or CCBs, help relax and widen blood vessels so the heart can pump blood more easily. They are widely prescribed to people with high blood pressure and some heart conditions.
Glaucoma is a group of eye diseases that damage the optic nerve, which carries visual information from the eye to the brain. The disease can slowly reduce eyesight and may eventually cause blindness if it is not detected and treated. Because early glaucoma often causes no obvious symptoms, many people do not know they have it.
The study was led by Dr. Alan Kastner of Moorfields Eye Hospital and University College London. The researchers examined health information from more than 427,000 adults in the United Kingdom, including 33,175 people who were taking calcium channel blockers. This large amount of data allowed the team to compare eye health in people using different types of blood pressure medicine.
The researchers found that people taking CCBs were more likely to have glaucoma than people who were not taking these medicines. The association remained after the team considered other factors that could influence glaucoma risk, including age, lifestyle and existing medical conditions. Other types of blood pressure medicines did not show the same association in the study.
One finding was particularly interesting because glaucoma is often connected with increased pressure inside the eye.
High eye pressure can gradually damage the optic nerve, which is why measuring eye pressure is an important part of glaucoma screening. However, the researchers found signs of glaucoma-related eye changes in some CCB users even when their eye pressure was not unusually high.
This suggests that calcium channel blockers could potentially be connected to glaucoma through a process that does not depend on eye pressure. Researchers do not yet know what that process might be. More studies will be needed to understand whether the medicines themselves contribute to the disease and, if so, how this happens.
The study also does not prove that CCBs cause glaucoma. Research based on health records can identify an association between a medicine and a disease, but other differences between patients may help explain the results. For this reason, the findings should be considered a reason for further investigation rather than proof of a direct cause.
People taking calcium channel blockers should not stop their medicine because of the study. High blood pressure can damage blood vessels throughout the body and greatly increases the risk of heart attack, stroke and other serious problems. Suddenly changing or stopping prescribed treatment without medical advice could be harmful.
Instead, people who are concerned can discuss the findings with their doctor and ask whether their individual risk factors need to be considered. Regular eye examinations may be especially valuable for people who already have an increased risk of glaucoma. Risk generally rises with age and can also be influenced by family history and other health factors.
Early detection matters because vision already lost from glaucoma usually cannot be restored. Treatment can often slow or prevent further damage, especially when the disease is found before major vision loss occurs. Eye checks can therefore play an important role even when a person feels that their eyesight is normal.
Dr. Kastner and his colleagues said further research is needed to confirm the association and understand the possible biological explanation behind it. Future studies could also help determine whether particular CCB medicines, doses or lengths of treatment are associated with different levels of risk.
The research was published in the peer-reviewed journal JAMA Ophthalmology. The findings add to ongoing research into how medicines used for common long-term conditions may have effects elsewhere in the body and could eventually help doctors make more informed treatment decisions.
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