To assess the impact of vascular risk factors on the prevalence of primary open angle
Population-based cross-sectional study.
Four thousand two hundred ninety-seven patients more than 40 years of age underwent
a complete ocular examination in the context of the Egna-Neumarkt Glaucoma Study.
Ocular examinations were performed by trained, quality-controlled ophthalmologists
according to a predefined standardized protocol including medical interview, blood
pressure reading, applanation tonometry, computerized perimetry, and optic nerve head
Prevalences of ocular hypertension, primary open-angle glaucoma, normal-tension glaucoma,
and other types of glaucoma were determined. Correlation coefficients were calculated
for the association between systemic blood pressure and age-adjusted intraocular pressure
(IOP) and between age and both intraocular and systemic blood pressures. Odds ratios
were computed to assess the risk of primary open-angle glaucoma and normal-tension
glaucoma in relation to systemic hypertension or antihypertensive medication, blood
pressure levels, diastolic perfusion pressure, and a number of other cardiovascular
A positive correlation was found between systemic blood pressure and IOP, and an association
was found between diagnosis of primary open-angle glaucoma and systemic hypertension.
Lower diastolic perfusion pressure is associated with a marked, progressive increase
in the frequency of hypertensive glaucoma. No relationship was found between systemic
diseases of vascular origin and glaucoma.
Our 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