Oral nitrates tied to lower risk of glaucoma in patients with chronic ischaemic heart disease

In patients with chronic ischaemic heart disease (IHD), the use of oral nitrates helps lower the risk of open-angle glaucoma (OAG) and primary open-angle glaucoma (POAG), according to a retrospective study.

Researchers used data from the TriNetX database and identified adults ages ≥40 years who had received a diagnosis of chronic IHD. Two cohorts were established, those with a prescription for oral nitrates (≥4 renewal prescriptions) and those without (control). Exclusion criteria included a prior diagnosis of glaucoma or ocular hypertension, as well as an indication for nitrates other than IHD. Propensity score matching (PSM) was performed to balance demographic, clinical, and socioeconomic factors.

Study endpoints included the risks of developing OAG, POAG, ocular hypertension, and the initiation of first-line glaucoma treatments over 1-, 3-, and 5-year follow-up periods from the index event.

PSM yielded 30,937 patients each in the nitrate user and nonuser control cohorts. Compared with controls, nitrate users had a significantly lower risk of OAG at 3 years (adjusted hazard ratio [aHR], 0.82, 95 percent confidence interval [CI], 0.71–0.95) and 5 years (aHR, 0.68, 95 percent CI, 0.58-0.79). Similarly, nitrate users had a reduced risk of POAG both at 3 years (aHR, 0.78, 95 percent CI, 0.67–0.92) and 5 years (aHR, 0.67, 95 percent CI, 0.57–0.79). However, nitrate use had a null association with ocular hypertension at any time point.

Finally, compared with nonuser controls, nitrate users were less likely to require first-line glaucoma therapy at 1 year (aHR, 0.72, 95 percent CI, 0.63–0.81), 3 years (aHR, 0.78, 95 percent CI, 0.71–0.85), and 5 years (aHR, 0.83, 95 percent CI, 0.75–0.91).