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Association between retinal vein occlusion and early-stage hypertension: A propensity score analysis using a large claims database

Eye volume 37, pages 1741–1747 (2023)Cite this article

Subjects

Abstract

Backgrounds/Objectives

The threshold of hypertension was lowered from systolic blood pressure (SBP)/diastolic blood pressure (DBP) 140/90 mmHg to 130/80 mmHg by the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guideline. Thus, we investigated the association between retinal vein occlusion (RVO) occurrence and early-stage hypertension.

Subjects/Methods

This retrospective cohort study used the JMDC Claims Database (JMDC Inc., Tokyo, Japan) between 2005 and 2020. Individuals undergoing health checkups who had data on BP and did not take antihypertensive medications were included. They were classified into four BP groups: normal BP (SBP < 120 mmHg and DBP < 80 mmHg), elevated BP (SBP 120–129 mmHg and DBP < 80 mmHg), stage 1 hypertension (SBP 130–139 mmHg or DBP 80–89 mmHg), and stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). Date of RVO occurrence was defined as the first date of diagnosis. We estimated adjusted hazard ratios for RVO and central RVO using weighted Cox regression to adjust for potential confounders.

Results

A total of 2,703,264 individuals were eligible. During a mean follow-up of 1,091 days, 3,526 RVO and 828 central RVO events occurred. The adjusted hazard ratios (95% confidence intervals) were 1.37 (1.19–1.57), 1.95 (1.75–2.18), and 3.33 (2.95–3.76) for RVO and 1.44 (1.07–1.93), 2.17 (1.72–2.73), and 3.76 (2.91–4.86) for central RVO in the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, compared with the normal BP group.

Conclusions

Even individuals with early-stage hypertension showed higher risks for RVO and central RVO than individuals with normal BP.

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Fig. 1: Patient selection.
Fig. 2: Cumulative incidence curves of any retinal vein occlusion weighted by matching weights.
Fig. 3: Cumulative incidence curves of central retinal vein occlusion weighted by matching weights.

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Data availability

We used de-identified, individual-level data obtained from the JMDC Claims Database (Tokyo, Japan). The address of their HP is https://www.jmdc.co.jp/en/index. Data are not publicly available.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907 and 21H03159). The sponsor or funding organization had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yohei Hashimoto, Makoto Aihara & Ryo Obata

  2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Yohei Hashimoto, Hiroki Matsui & Hideo Yasunaga

  3. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan

    Hidehiro Kaneko

  4. Department of Biostatistics & Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Shotaro Aso

  5. Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Akira Okada

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  1. Yohei Hashimoto
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Contributions

YH had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YH, HK, AO, HY, and RO. Acquisition, analysis, and interpretation of data: YH, HK, SA, AO, HM, HY, RO. Drafting of the manuscript: YH, HK, HY, and AO. Critical revision of the manuscript for important intellectual content: YH. Statistical analysis: YH, SA, AO, and HY. Obtained funding: HY. Administrative, technical, or material support: None. Study supervision: HY and AO.

Corresponding author

Correspondence to Yohei Hashimoto.

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Supplementary information

Study design

Standardized mean differences before and after weighting.

41433_2022_2241_MOESM3_ESM.docx

Hazard ratios for any retinal vein occlusion and central retinal vein occlusion before and after weighting in the individuals aged <40 years

41433_2022_2241_MOESM4_ESM.docx

Hazard ratios for any retinal vein occlusion and central retinal vein occlusion before and after weighting in the individuals aged ≥40 years

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Hashimoto, Y., Kaneko, H., Aso, S. et al. Association between retinal vein occlusion and early-stage hypertension: A propensity score analysis using a large claims database. Eye 37, 1741–1747 (2023). https://doi.org/10.1038/s41433-022-02241-w

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