Primary Open-angle Glaucoma, Intraocular Pressure, and Systemic Blood Pressure in the General Elderly Population: The Rotterdam Study
TL;DR: Systemic blood pressure and hypertension are associated with IOP and high-tension glaucoma, and no association was found between blood pressure or hypertension and normal-Tension glAUcoma.
About: This article is published in Ophthalmology.The article was published on 1995-01-01. It has received 350 citations till now. The article focuses on the topics: Intraocular pressure & Open angle glaucoma.
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TL;DR: The rationale of the study and its design is given, and a summary of the major findings and an update of the objectives and methods are presented.
Abstract: The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.
1,448 citations
TL;DR: Treatment and follow-up IOP continued to have a marked influence on progression, regardless of baseline IOP, and lower systolic perfusion pressure, lower syStolic BP, and cardiovascular disease history emerged as new predictors, suggesting a vascular role in glaucoma progression.
1,232 citations
TL;DR: The data are in line with those reported in other recent epidemiologic studies and show that reduced diastolic perfusion pressure is an important risk factor for primary open-angle glaucoma.
665 citations
TL;DR: Recognition of the ocular effects of blood pressure could allow physicians to better manage patients with hypertension, and to monitor its end-organ effects.
537 citations
TL;DR: Open-angle glaucoma (OAG) was defined using a proposed international system for prevalence surveys, including threshold visual field defect and optic disc damage as mentioned in this paper, and bilateral appositional angle closure was combined with optic nerve damage (judged by field and disc as for OAG).
Abstract: Objective To determine the prevalence of glaucoma in a population-based sample of Hispanic adults older than 40 years. Methods Using 1990 census data for Arizona, groups of persons living in sections of the city in Nogales and Tucson were randomly selected with a probability proportional to the Hispanic population older than 40 years. We tried to recruit all eligible adults in homes with 1 self-described Hispanic adult. Detailed ocular examinations at a local clinic included visual acuity testing, applanation tonometry, gonioscopy, an optic disc evaluation, and a threshold visual field test. Open-angle glaucoma (OAG) was defined using a proposed international system for prevalence surveys, including threshold visual field defect and optic disc damage. Angle-closure glaucoma was defined as bilateral appositional angle closure, combined with optic nerve damage (judged by field and disc as for OAG). Results Examinations were conducted in 72% (4774/6658) of eligible persons, with a 1.97% prevalence (95% confidence interval, 1.58%-2.36%) of OAG (94 persons). The age-specific OAG prevalence increased nonlinearly from 0.50% in those aged 41 to 49 years to 12.63% in those 80 years and older. Angle-closure glaucoma was detected in 5 persons (0.10%). Sex, blood pressure, and cigarette smoking were not significant OAG risk factors. Only 36 (38%) of the 94 persons with OAG were aware of their OAG before the study. Screening results with an intraocular pressure higher than 22 mm Hg (in the eye with a higher pressure) would miss 80% of the OAG cases. Conclusions The prevalence of OAG in Hispanic persons was intermediate between reported values for white and black persons. The prevalence increased more quickly with increasing age than in other ethnic groups. Glaucoma was the leading cause of bilateral blindness.
526 citations
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1,514 citations
TL;DR: The prevalence of diabetic retinopathy was examined in people with newly discovered noninsulin-dependent diabetes mellitus (NIDDM) (n = 50) and in those with previously diagnosed diabetes.
1,397 citations
TL;DR: The Rotterdam Elderly Study as discussed by the authors investigated determinants of disease occurrence and progression in the elderly in order to contribute to the understanding of the etiology of geriatric illnesses and to lead to specific recommendations for intervention.
Abstract: In this paper the Rotterdam Elderly Study is presented. The aim of the study is to investigate determinants of disease occurrence and progression in the elderly. In addition to contributing to our understanding of the etiology of geriatric illnesses, the study is expected to lead to specific recommendations for intervention. The study focuses on causally related determinants of major diseases in the elderly. Fields of interest for the Rotterdam Elderly Study are conditions which interfere the most with the quality of life for the elderly. The aims of the Rotterdam Elderly Study are: (1) To investigate, by means of epidemiologic, clinical and basic research, the determinants of diseases in order to assess their etiologic significance. (2) To investigate potentially modifiable determinants in order to be able to develop preventive strategies by providing specific recommendations for intervention studies. The Rotterdam Elderly Study focuses on four primary areas of research: neurogeriatric diseases, cardiovascular diseases, locomotor diseases and ophthalmologic diseases. It is a prospective follow-up study, in which determinants of disease and determinants of progression of disease will be investigated in the total population of 55 years or over of the district of Ommoord in Rotterdam. It is anticipated that about 10,000 people will participate in the study and they will be examined in the period of 1991 to 1995.
1,147 citations
TL;DR: This report updates findings of previous reports in several respects: it broadens the step-care approach to provide more flexibility for clinicians; encourages greater patient involvement in the treatment program; emphasizes a consideration of the quality of life in the management of patients; and addresses the cost of care.
Abstract: • The National High Blood Pressure Education Program has released three Joint National Committee reports and a task force report on the detection, evaluation, and treatment of high blood pressure. Like its predecessors, the 1988 Joint National Committee report was developed using the consensus process; it is based on the latest scientific research and reflects the state of the art regarding hypertension management. This report updates findings of previous reports in several respects: it broadens the step-care approach to provide more flexibility for clinicians; encourages greater patient involvement in the treatment program; emphasizes a consideration of the quality of life in the management of patients; and addresses the cost of care. It also provides more emphasis on control of other risk factors for cardiovascular disease; includes a discussion of the new cholesterol guidelines; recommends a reduction in alcohol consumption; and discusses the use of calcium and fish oil supplementation. This document expands earlier reports on special populations, including blacks and other racial and ethnic minority groups, young and elderly patients, pregnant patients, surgical candidates, and hypertensive patients with cerebrovascular disease, coronary artery disease, left ventricular hypertrophy, congestive heart failure, peripheral vascular disease, renal disease, chronic obstructive pulmonary disease or bronchial asthma, gout, diabetes mellitus, and hyperlipidemia. The report also updates previous drug tables to include new drugs, revised recommended doses of some drugs, and drug interactions. Consideration of step-down therapy after blood pressure has been controlled is suggested. This report is intended as a guide for practicing physicians and other health professionals in their care of hypertensive patients and as a reference for those participating in the many community high blood pressure control programs throughout the country. (Arch Intern Med1988;148:1023-1038)
1,025 citations
TL;DR: The prevalence of open-angle glaucoma in Beaver Dam is similar to that in other white populations, and findings from this study re-emphasize the notion that estimates of glauca prevalence should be based on assessing multiple risk indicators.
976 citations