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Arterial Stiffness May Predict Risk for Glaucoma
TOPLINE:
Arterial stiffness increases the risk for developing glaucoma, a new study found.
METHODOLOGY:
- To study the link between arterial stiffness and glaucoma, the researchers evaluated 4713 individuals (mean age, 66 years; 58% men) without the eye condition at baseline between April 2011 and November 2012.
- They assessed arterial stiffness by measuring aortic pulse wave velocity, estimated carotid-femoral pulse wave velocity, and aortic pulse pressure.
- The primary outcome was incident glaucoma, identified from prescriptions for eye drops or hospital records.
TAKEAWAY:
- Overall, 301 people in the study developed glaucoma over a mean follow-up period of 10.5 years.
- Incident glaucoma increased across all quartiles of arterial stiffness, with the highest risk observed in the fourth quartile for aortic pulse wave velocity (HR, 2.41; 95% CI, 1.36-4.26), estimated carotid-femoral pulse wave velocity (HR, 2.29; 95% CI, 1.27-4.13), and aortic pulse pressure (HR, 1.76; 95% CI, 1.10-2.82).
- The cumulative incidence of glaucoma rose with increases in arterial stiffness. This trend was statistically significant for both aortic and estimated pulse wave velocity (P < .0001) and aortic pulse pressure (P = .02).
IN PRACTICE:
“Arterial stiffness…which can be easily and accurately measured, could be used as a tool in clinical practice [as part of routine blood pressure measurement] to help identify people at risk of glaucoma and as a therapeutic target to prevent glaucoma progression,” the authors wrote.
SOURCE:
This study was led by Angela L. Beros, MPH, of the School of Population Health at the University of Auckland, Auckland, New Zealand, and published online in the American Journal of Ophthalmology.
LIMITATIONS:
The cohort study did not clinically assess for glaucoma, potentially leading to the inclusion of individuals with the condition. Not all participants with incident glaucoma, particularly those unaware of their diagnosis, may have been identified. Intraocular pressure and central corneal thickness, which are common risk factors for glaucoma, were not included in the multivariate analysis.
DISCLOSURES:
The study did not receive any funding. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
Arterial stiffness increases the risk for developing glaucoma, a new study found.
METHODOLOGY:
- To study the link between arterial stiffness and glaucoma, the researchers evaluated 4713 individuals (mean age, 66 years; 58% men) without the eye condition at baseline between April 2011 and November 2012.
- They assessed arterial stiffness by measuring aortic pulse wave velocity, estimated carotid-femoral pulse wave velocity, and aortic pulse pressure.
- The primary outcome was incident glaucoma, identified from prescriptions for eye drops or hospital records.
TAKEAWAY:
- Overall, 301 people in the study developed glaucoma over a mean follow-up period of 10.5 years.
- Incident glaucoma increased across all quartiles of arterial stiffness, with the highest risk observed in the fourth quartile for aortic pulse wave velocity (HR, 2.41; 95% CI, 1.36-4.26), estimated carotid-femoral pulse wave velocity (HR, 2.29; 95% CI, 1.27-4.13), and aortic pulse pressure (HR, 1.76; 95% CI, 1.10-2.82).
- The cumulative incidence of glaucoma rose with increases in arterial stiffness. This trend was statistically significant for both aortic and estimated pulse wave velocity (P < .0001) and aortic pulse pressure (P = .02).
IN PRACTICE:
“Arterial stiffness…which can be easily and accurately measured, could be used as a tool in clinical practice [as part of routine blood pressure measurement] to help identify people at risk of glaucoma and as a therapeutic target to prevent glaucoma progression,” the authors wrote.
SOURCE:
This study was led by Angela L. Beros, MPH, of the School of Population Health at the University of Auckland, Auckland, New Zealand, and published online in the American Journal of Ophthalmology.
LIMITATIONS:
The cohort study did not clinically assess for glaucoma, potentially leading to the inclusion of individuals with the condition. Not all participants with incident glaucoma, particularly those unaware of their diagnosis, may have been identified. Intraocular pressure and central corneal thickness, which are common risk factors for glaucoma, were not included in the multivariate analysis.
DISCLOSURES:
The study did not receive any funding. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
Arterial stiffness increases the risk for developing glaucoma, a new study found.
METHODOLOGY:
- To study the link between arterial stiffness and glaucoma, the researchers evaluated 4713 individuals (mean age, 66 years; 58% men) without the eye condition at baseline between April 2011 and November 2012.
- They assessed arterial stiffness by measuring aortic pulse wave velocity, estimated carotid-femoral pulse wave velocity, and aortic pulse pressure.
- The primary outcome was incident glaucoma, identified from prescriptions for eye drops or hospital records.
TAKEAWAY:
- Overall, 301 people in the study developed glaucoma over a mean follow-up period of 10.5 years.
- Incident glaucoma increased across all quartiles of arterial stiffness, with the highest risk observed in the fourth quartile for aortic pulse wave velocity (HR, 2.41; 95% CI, 1.36-4.26), estimated carotid-femoral pulse wave velocity (HR, 2.29; 95% CI, 1.27-4.13), and aortic pulse pressure (HR, 1.76; 95% CI, 1.10-2.82).
- The cumulative incidence of glaucoma rose with increases in arterial stiffness. This trend was statistically significant for both aortic and estimated pulse wave velocity (P < .0001) and aortic pulse pressure (P = .02).
IN PRACTICE:
“Arterial stiffness…which can be easily and accurately measured, could be used as a tool in clinical practice [as part of routine blood pressure measurement] to help identify people at risk of glaucoma and as a therapeutic target to prevent glaucoma progression,” the authors wrote.
SOURCE:
This study was led by Angela L. Beros, MPH, of the School of Population Health at the University of Auckland, Auckland, New Zealand, and published online in the American Journal of Ophthalmology.
LIMITATIONS:
The cohort study did not clinically assess for glaucoma, potentially leading to the inclusion of individuals with the condition. Not all participants with incident glaucoma, particularly those unaware of their diagnosis, may have been identified. Intraocular pressure and central corneal thickness, which are common risk factors for glaucoma, were not included in the multivariate analysis.
DISCLOSURES:
The study did not receive any funding. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
CVD Risk Rises With Higher NSAID Doses in Ankylosing Spondylitis
TOPLINE:
Higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk for cardiovascular diseases (CVDs) such as ischemic heart disease, stroke, and congestive heart failure in patients with ankylosing spondylitis (AS) compared with lower doses.
METHODOLOGY:
- NSAIDs can suppress inflammation and relieve pain in patients with AS, but long-term treatment with NSAIDs poses concerns regarding gastrointestinal and renal toxicities and increased CVD risk.
- This nationwide cohort study used data from the Korean National Health Insurance database to investigate the risk for CVD associated with an increasing NSAID dosage in a real-world AS cohort.
- Investigators recruited 19,775 patients (mean age, 36.1 years; 75% men) with newly diagnosed AS and without any prior CVD between January 2010 and December 2018, among whom 99.7% received NSAID treatment and 30.2% received tumor necrosis factor inhibitor treatment.
- A time-varying approach was used to assess the NSAID exposure, wherein periods of NSAID use were defined as “NSAID-exposed” and periods longer than 1 month without NSAID use were defined as “NSAID-unexposed.”
- The primary outcome was the composite outcome of ischemic heart disease, stroke, or congestive heart failure.
TAKEAWAY:
- During the follow-up period of 98,290 person-years, 1663 cases of CVD were identified, which included 1157 cases of ischemic heart disease, 301 cases of stroke, and 613 cases of congestive heart failure.
- After adjusting for confounders, each defined daily dose increase in NSAIDs raised the risk for incident CVD by 10% (adjusted hazard ratio [aHR], 1.10; 95% CI, 1.08-1.13).
- Similarly, increasing the dose of NSAIDs was associated with an increased risk for ischemic heart disease (aHR, 1.08; 95% CI, 1.05-1.11), stroke (aHR, 1.09; 95% CI, 1.04-1.15), and congestive heart failure (aHR, 1.12; 95% CI, 1.08-1.16).
- The association between increasing NSAID dose and increased CVD risk was consistent across various subgroups, with NSAIDs posing a greater threat to cardiovascular health in women than in men.
IN PRACTICE:
The authors wrote, “Taken together, these results suggest that increasing the dose of NSAIDs is associated with a higher cardiovascular risk in AS, but that the increased risk might be lower than that in the general population.”
SOURCE:
First author Ji-Won Kim, MD, PhD, of the Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, the Republic of Korea, and colleagues had their work published online on April 9 in Annals of the Rheumatic Diseases.
LIMITATIONS:
The study was of retrospective nature. The levels of acute phase reactants and AS disease activity could not be determined owing to a lack of data in the National Health Insurance database. The accuracy of the diagnosis of cardiovascular outcomes on the basis of the International Classification of Disease codes was also questionable.
DISCLOSURES:
The study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
Higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk for cardiovascular diseases (CVDs) such as ischemic heart disease, stroke, and congestive heart failure in patients with ankylosing spondylitis (AS) compared with lower doses.
METHODOLOGY:
- NSAIDs can suppress inflammation and relieve pain in patients with AS, but long-term treatment with NSAIDs poses concerns regarding gastrointestinal and renal toxicities and increased CVD risk.
- This nationwide cohort study used data from the Korean National Health Insurance database to investigate the risk for CVD associated with an increasing NSAID dosage in a real-world AS cohort.
- Investigators recruited 19,775 patients (mean age, 36.1 years; 75% men) with newly diagnosed AS and without any prior CVD between January 2010 and December 2018, among whom 99.7% received NSAID treatment and 30.2% received tumor necrosis factor inhibitor treatment.
- A time-varying approach was used to assess the NSAID exposure, wherein periods of NSAID use were defined as “NSAID-exposed” and periods longer than 1 month without NSAID use were defined as “NSAID-unexposed.”
- The primary outcome was the composite outcome of ischemic heart disease, stroke, or congestive heart failure.
TAKEAWAY:
- During the follow-up period of 98,290 person-years, 1663 cases of CVD were identified, which included 1157 cases of ischemic heart disease, 301 cases of stroke, and 613 cases of congestive heart failure.
- After adjusting for confounders, each defined daily dose increase in NSAIDs raised the risk for incident CVD by 10% (adjusted hazard ratio [aHR], 1.10; 95% CI, 1.08-1.13).
- Similarly, increasing the dose of NSAIDs was associated with an increased risk for ischemic heart disease (aHR, 1.08; 95% CI, 1.05-1.11), stroke (aHR, 1.09; 95% CI, 1.04-1.15), and congestive heart failure (aHR, 1.12; 95% CI, 1.08-1.16).
- The association between increasing NSAID dose and increased CVD risk was consistent across various subgroups, with NSAIDs posing a greater threat to cardiovascular health in women than in men.
IN PRACTICE:
The authors wrote, “Taken together, these results suggest that increasing the dose of NSAIDs is associated with a higher cardiovascular risk in AS, but that the increased risk might be lower than that in the general population.”
SOURCE:
First author Ji-Won Kim, MD, PhD, of the Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, the Republic of Korea, and colleagues had their work published online on April 9 in Annals of the Rheumatic Diseases.
LIMITATIONS:
The study was of retrospective nature. The levels of acute phase reactants and AS disease activity could not be determined owing to a lack of data in the National Health Insurance database. The accuracy of the diagnosis of cardiovascular outcomes on the basis of the International Classification of Disease codes was also questionable.
DISCLOSURES:
The study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
Higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk for cardiovascular diseases (CVDs) such as ischemic heart disease, stroke, and congestive heart failure in patients with ankylosing spondylitis (AS) compared with lower doses.
METHODOLOGY:
- NSAIDs can suppress inflammation and relieve pain in patients with AS, but long-term treatment with NSAIDs poses concerns regarding gastrointestinal and renal toxicities and increased CVD risk.
- This nationwide cohort study used data from the Korean National Health Insurance database to investigate the risk for CVD associated with an increasing NSAID dosage in a real-world AS cohort.
- Investigators recruited 19,775 patients (mean age, 36.1 years; 75% men) with newly diagnosed AS and without any prior CVD between January 2010 and December 2018, among whom 99.7% received NSAID treatment and 30.2% received tumor necrosis factor inhibitor treatment.
- A time-varying approach was used to assess the NSAID exposure, wherein periods of NSAID use were defined as “NSAID-exposed” and periods longer than 1 month without NSAID use were defined as “NSAID-unexposed.”
- The primary outcome was the composite outcome of ischemic heart disease, stroke, or congestive heart failure.
TAKEAWAY:
- During the follow-up period of 98,290 person-years, 1663 cases of CVD were identified, which included 1157 cases of ischemic heart disease, 301 cases of stroke, and 613 cases of congestive heart failure.
- After adjusting for confounders, each defined daily dose increase in NSAIDs raised the risk for incident CVD by 10% (adjusted hazard ratio [aHR], 1.10; 95% CI, 1.08-1.13).
- Similarly, increasing the dose of NSAIDs was associated with an increased risk for ischemic heart disease (aHR, 1.08; 95% CI, 1.05-1.11), stroke (aHR, 1.09; 95% CI, 1.04-1.15), and congestive heart failure (aHR, 1.12; 95% CI, 1.08-1.16).
- The association between increasing NSAID dose and increased CVD risk was consistent across various subgroups, with NSAIDs posing a greater threat to cardiovascular health in women than in men.
IN PRACTICE:
The authors wrote, “Taken together, these results suggest that increasing the dose of NSAIDs is associated with a higher cardiovascular risk in AS, but that the increased risk might be lower than that in the general population.”
SOURCE:
First author Ji-Won Kim, MD, PhD, of the Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, the Republic of Korea, and colleagues had their work published online on April 9 in Annals of the Rheumatic Diseases.
LIMITATIONS:
The study was of retrospective nature. The levels of acute phase reactants and AS disease activity could not be determined owing to a lack of data in the National Health Insurance database. The accuracy of the diagnosis of cardiovascular outcomes on the basis of the International Classification of Disease codes was also questionable.
DISCLOSURES:
The study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
Worldwide Prevalence of Psoriatic Arthritis More Precisely Determined
TOPLINE:
According to this meta-analysis, psoriatic arthritis (PsA) affects 112 out of every 100,000 adults globally, with higher rates observed in Europe and North America than in Asia and South America, according to an analysis of 30 studies.
METHODOLOGY:
- Many previous epidemiological studies have estimated the global prevalence of PsA but have reported marked variations, which could be explained by differences in methodology and inclusion criteria.
- This meta-analysis used data from 30 studies conducted between 1982 and 2020 to estimate the worldwide prevalence of PsA in the general adult population, giving particular attention to methodological differences among the included studies.
- The included studies were either population-based (n = 13) or based on health administrative records (n = 17) and covered over 180 million adults across 24 countries.
- Overall, 15 studies were from Europe, seven from Asia, six from North America, and two from South America.
TAKEAWAY:
- The global prevalence of PsA was estimated at 113 (95% CI, 64-198) and 109 (75-158) cases per 100,000 based on population-based studies and health administrative data studies, respectively.
- The pooled global prevalence of PsA (combining the population-based and health administrative studies) was 112 cases per 100,000 (95% CI, 83-151).
- Combining both study designs, the global prevalence rates of PsA were 188 (95% CI, 128-289) cases per 100,000 for Europe, 48 (95% CI, 20-115) for Asia, 133 (95% CI, 93-191) for North America, and 17 (95% CI, 4-70) for South America.
IN PRACTICE:
“Robust estimates of prevalence are crucial for healthcare planning and resource allocation,” wrote the authors.
SOURCE:
The study was conducted by Stephanie Lembke, MSc, and colleagues from the Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland. It was published online in Rheumatology (Oxford).
LIMITATIONS:
The meta-analysis had high levels of uncertainty and high heterogeneity between studies. In countries with unequal healthcare access, using data from statutory or private insurance databases to calculate PsA prevalence may systematically exclude uninsured individuals or those covered by private insurers. Moreover, the data were insufficient for a statistically meaningful subgroup analysis.
DISCLOSURES:
The study did not receive any specific funding from any public, commercial, or nonprofit sectors to carry out this work. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
According to this meta-analysis, psoriatic arthritis (PsA) affects 112 out of every 100,000 adults globally, with higher rates observed in Europe and North America than in Asia and South America, according to an analysis of 30 studies.
METHODOLOGY:
- Many previous epidemiological studies have estimated the global prevalence of PsA but have reported marked variations, which could be explained by differences in methodology and inclusion criteria.
- This meta-analysis used data from 30 studies conducted between 1982 and 2020 to estimate the worldwide prevalence of PsA in the general adult population, giving particular attention to methodological differences among the included studies.
- The included studies were either population-based (n = 13) or based on health administrative records (n = 17) and covered over 180 million adults across 24 countries.
- Overall, 15 studies were from Europe, seven from Asia, six from North America, and two from South America.
TAKEAWAY:
- The global prevalence of PsA was estimated at 113 (95% CI, 64-198) and 109 (75-158) cases per 100,000 based on population-based studies and health administrative data studies, respectively.
- The pooled global prevalence of PsA (combining the population-based and health administrative studies) was 112 cases per 100,000 (95% CI, 83-151).
- Combining both study designs, the global prevalence rates of PsA were 188 (95% CI, 128-289) cases per 100,000 for Europe, 48 (95% CI, 20-115) for Asia, 133 (95% CI, 93-191) for North America, and 17 (95% CI, 4-70) for South America.
IN PRACTICE:
“Robust estimates of prevalence are crucial for healthcare planning and resource allocation,” wrote the authors.
SOURCE:
The study was conducted by Stephanie Lembke, MSc, and colleagues from the Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland. It was published online in Rheumatology (Oxford).
LIMITATIONS:
The meta-analysis had high levels of uncertainty and high heterogeneity between studies. In countries with unequal healthcare access, using data from statutory or private insurance databases to calculate PsA prevalence may systematically exclude uninsured individuals or those covered by private insurers. Moreover, the data were insufficient for a statistically meaningful subgroup analysis.
DISCLOSURES:
The study did not receive any specific funding from any public, commercial, or nonprofit sectors to carry out this work. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.
TOPLINE:
According to this meta-analysis, psoriatic arthritis (PsA) affects 112 out of every 100,000 adults globally, with higher rates observed in Europe and North America than in Asia and South America, according to an analysis of 30 studies.
METHODOLOGY:
- Many previous epidemiological studies have estimated the global prevalence of PsA but have reported marked variations, which could be explained by differences in methodology and inclusion criteria.
- This meta-analysis used data from 30 studies conducted between 1982 and 2020 to estimate the worldwide prevalence of PsA in the general adult population, giving particular attention to methodological differences among the included studies.
- The included studies were either population-based (n = 13) or based on health administrative records (n = 17) and covered over 180 million adults across 24 countries.
- Overall, 15 studies were from Europe, seven from Asia, six from North America, and two from South America.
TAKEAWAY:
- The global prevalence of PsA was estimated at 113 (95% CI, 64-198) and 109 (75-158) cases per 100,000 based on population-based studies and health administrative data studies, respectively.
- The pooled global prevalence of PsA (combining the population-based and health administrative studies) was 112 cases per 100,000 (95% CI, 83-151).
- Combining both study designs, the global prevalence rates of PsA were 188 (95% CI, 128-289) cases per 100,000 for Europe, 48 (95% CI, 20-115) for Asia, 133 (95% CI, 93-191) for North America, and 17 (95% CI, 4-70) for South America.
IN PRACTICE:
“Robust estimates of prevalence are crucial for healthcare planning and resource allocation,” wrote the authors.
SOURCE:
The study was conducted by Stephanie Lembke, MSc, and colleagues from the Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland. It was published online in Rheumatology (Oxford).
LIMITATIONS:
The meta-analysis had high levels of uncertainty and high heterogeneity between studies. In countries with unequal healthcare access, using data from statutory or private insurance databases to calculate PsA prevalence may systematically exclude uninsured individuals or those covered by private insurers. Moreover, the data were insufficient for a statistically meaningful subgroup analysis.
DISCLOSURES:
The study did not receive any specific funding from any public, commercial, or nonprofit sectors to carry out this work. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.