Arterial Stiffness Linked to Higher Risk of Glaucoma: Landmark Population Study Reveals

The study, published in the American Journal of Ophthalmology, found that arterial stiffness increases the risk of developing glaucoma.

"Arterial stiffness measured with a simple oscillometric device predicts glaucoma development and could potentially be used in clinical practice to help identify people at risk of this condition," the researchers wrote. "It may also present a new therapeutic research avenue, including concerning systemic antihypertensives."

Glaucoma, a leading cause of irreversible blindness worldwide, has long been attributed to elevated intraocular pressure (IOP). However, this latest research delves deeper into the intricate relationship between vascular health and ocular pathology. Arterial stiffness, a hallmark of vascular aging and a predictor of cardiovascular risk is a potential indicator of glaucoma susceptibility.

Angela L BEROS, School of Population Health, University of Auckland, Auckland, New Zealand, and colleagues aimed to investigate whether arterial stiffness, assessed oscillometrically, is associated with incident glaucoma in the Vitamin D Assessment (ViDA) Study cohort aged 50-84 years.

For this purpose, the researchers conducted a prospective, population-based cohort study in which arterial stiffness was assessed in 4713 participants without known glaucoma (mean±SD age = 66±8 years) from 2011 to 2012 by way of aortic PWV (aPWV), estimated carotid-femoral PWV (ePWV) and aortic PP (aPP).

Glaucoma identification was through linkage to national prescription and hospital discharge registers. Cox proportional hazards regression estimated the relative risks of glaucoma for each arterial stiffness measure over the continuum of values and by quartiles.

The study led to the following findings:

· During a mean follow-up of 10.5 years, 301 participants developed glaucoma.

· Arterial stiffness, as measured by aPWV (Hazard ratio (HR) per SD increase, 1.36) and ePWV (HR per SD increase, 1.40) but not aPP (HR per SD increase, 1.06) was associated with incident glaucoma.

· When arterial stiffness was analyzed as a categorical variable, the highest quartiles of aPWV (HR, 2.62), ePWV (HR, 2.42), and aPP (HR, 1.68) were associated with glaucoma development.

"Arterial stiffness, which can be accurately and easily measured, could be used as a tool in clinical practice [as part of routine blood pressure measurement] to identify people at glaucoma risk and as a therapeutic target to prevent glaucoma progression," the authors wrote.

In essence, this landmark study not only expands our understanding of glaucoma pathogenesis but also underscores the pivotal role of vascular health in ocular disease. As research unravels the intricate interplay between systemic and ocular factors, the prospect of personalized preventive strategies holds promise for preserving vision and enhancing overall health.

Reference:

Beros AL, Sluyter JD, Hughes AD, Hametner B, Wassertheurer S, Scragg PRK. Arterial stiffness and incident glaucoma: a large population-based cohort study. Am J Ophthalmol. 2024 May 14:S0002-9394(24)00215-0. doi: 10.1016/j.ajo.2024.05.015. Epub ahead of print. PMID: 38754800.