8 INTERNATIONAL RESEARCH & OPINION Unde.rtreabnent of glaucoma not warranted Undertreatment of glaucoma to avoid potential cardiovascular adverse effects does not appear to be warranted. Exposure to topical P-blockers or other antiglaucoma agents did not increase the rate of occurrence of major cardiovascular events and appeared to be ·protective'. This is the finding of a US study involving participants (aged 65-99 years) in the New Jersey Medicaid and Medicare programme from 1986 to 1990. Within the study, a congestive heart failure analysis involved 11 426 new users of digoxin or a loop diuretic and a population of 24 019 controls. 1693 participants who had a pacemaker inserted between 1986 and 1990 were included in a conduction disorder analysis along with 2585 controls. Nearly 5% of both study populations used glaucoma preparations during the 45 days preceding the study. Interestingly, patients who started therapy for congestive heart failure (CHF) were less likely to use glaucoma medications than control participants. After exposure to glaucoma medication, there was a trend toward decreased likelihood of beginning therapy for CHF. P-blockade of the heart can improve ventricular filling, therefore systemic absorption of ophthalmic P-blockers may act by reducing diastolic dysfunction, suggest the researchers. Furthermore. the relative risk for pacemaker placement was not increased among subjects who received glaucoma preparations. On the other hand. advancing age. institutionalisation and multiple drug use were significantly associated with an increased likelihood of initiating treatment for CHF. Advancing age, large prescription numbers and treatment with digoxin were associated with an increased likelihood of pacemaker insertion. Monane M. Sohn RL. Gurwitz JH. Glynn RJ. Choodnovskiy I. et al. Topical glaucoma medications and cardiovascular risk in the elderly. Clinical Phannacology and Therapeutics 55: 76-83. Jan 1994 .002"'61 2 Apr 1994 PHARMACORESOURCEs" 1172.8299/94/0002.00081$01.00° Adis International Limited 1994. All rights reserved

Undertreatment of glaucoma not warranted

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Page 1: Undertreatment of glaucoma not warranted

8 INTERNATIONAL RESEARCH & OPINION

Unde.rtreabnent of glaucoma not warranted

Undertreatment of glaucoma to avoid potential cardiovascular adverse effects does not appear to be warranted. Exposure to topical P-blockers or other antiglaucoma agents did not increase the rate of occurrence of major cardiovascular events and appeared to be ·protective'.

This is the finding of a US study involving participants (aged 65-99 years) in the New Jersey Medicaid and Medicare programme from 1986 to 1990. Within the study, a congestive heart failure analysis involved 11 426 new users of digoxin or a loop diuretic and a population of 24 019 controls. 1693 participants who had a pacemaker inserted between 1986 and 1990 were included in a conduction disorder analysis along with 2585 controls.

Nearly 5% of both study populations used glaucoma preparations during the 45 days preceding the study. Interestingly, patients who started therapy for congestive heart failure (CHF) were less likely to use glaucoma medications than control participants.

After exposure to glaucoma medication, there was a trend toward decreased likelihood of beginning therapy for CHF. P-blockade of the heart can improve ventricular filling, therefore systemic absorption of ophthalmic P-blockers may act by reducing diastolic dysfunction, suggest the researchers. Furthermore. the relative risk for pacemaker placement was not increased among subjects who received glaucoma preparations.

On the other hand. advancing age. institutionalisation and multiple drug use were significantly associated with an increased likelihood of initiating treatment for CHF. Advancing age, large prescription numbers and treatment with digoxin were associated with an increased likelihood of pacemaker insertion.

Monane M. Sohn RL. Gurwitz JH. Glynn RJ. Choodnovskiy I. et al. Topical glaucoma medications and cardiovascular risk in the elderly. Clinical Phannacology and Therapeutics 55: 76-83. Jan 1994 .002"'61