Cardiovascular Risk Factors Linked to Increased Primary Open-Angle Glaucoma Risk in Glaucoma Suspects: Study Finds

The large Korean study that followed 362,285 individuals over six years revealed that those with diabetes had a 35.4% higher risk of progressing to primary open-angle glaucoma. Additionally, individuals with hypertension, dyslipidemia, and coronary heart disease faced increased risks of 13.9%, 12.8%, and 12.4%, respectively. The findings were published online in Scientific Reports on January 14, 2025.

Primary open-angle glaucoma, one of the leading causes of blindness worldwide, is a progressive eye disease characterized by damage to the optic nerve, often associated with increased intraocular pressure (IOP). Glaucoma suspects are individuals who show signs of possible glaucoma but do not yet meet the diagnostic criteria for the condition. These individuals are often monitored for any progression into full-blown glaucoma, as early detection and intervention can significantly impact disease management.

Against the above background, Chan Kee Park, Seoul St. Mary’s Hospital, Seoul, Korea, and colleagues explored the risk of primary open-angle glaucoma in individuals classified as glaucoma suspects and analyzed the cardiovascular risk factors associated with the condition.

For this purpose, the researchers conducted a longitudinal, nationwide cohort study utilizing the Korean National Health Insurance Service (KNHIS) data, including 362,285 participants aged 40 years and older from the Korean National Health Screening Program (NHSP). The study focused on individuals without pre-existing POAG in 2009 and 2010. Among these, 32,220 were classified as glaucoma suspects, defined as those with at least two recorded instances of the KCD code H400 for glaucoma suspects and no prior prescriptions for antiglaucoma medications before the health screening. The primary outcome was the diagnosis of POAG and the subsequent prescription of antiglaucoma medications.

The study revealed the following findings:

• Over a 6-year follow-up period, 4.92% of glaucoma suspects progressed to primary open-angle glaucoma.
• Multivariate Cox regression analysis showed that glaucoma suspects with diabetes, hypertension, dyslipidemia, or coronary heart disease had a higher risk of developing POAG compared to those without these comorbidities.
• The hazard ratio (HR) for diabetes was 1.354.
• For systemic hypertension, the HR was 1.139.
• The HR for dyslipidemia was 1.128.
• For coronary heart disease, the HR was 1.124.

In conclusion, the nationwide, population-based cohort study revealed that glaucoma suspects are at a higher risk of developing primary open-angle glaucoma compared to the general population. Additionally, individuals with cardiovascular risk factors or diseases face an even greater risk.

"These findings highlight the significant role of cardiovascular health in the development of glaucoma, emphasizing the need for increased clinical attention for glaucoma suspects with cardiovascular risk factors," the researchers wrote.

Reference:

Jung, K. I., Kim, Y. C., Shin, H. J., & Park, C. K. (2025). Nationwide cohort study of primary open angle glaucoma risk and cardiovascular factors among in Korean glaucoma suspects. Scientific Reports, 15(1), 1-11. https://doi.org/10.1038/s41598-025-85505-1