Hypertension as a risk factor for retinal vein occlusion in menopausal women: A nationwide Korean population-based study

Abstract

Retinal vein occlusion (RVO) is an important cause of blindness. Hypertension is a well-known risk factor for RVO. Although the prevalence of hypertension increases in women after menopause, the relationship between blood pressure and RVO in women before and after menopause has not been studied in detail.We retrospectively analyzed 2,619,206 patients from the Korean National Health Insurance System database. A Cox proportional hazard regression model was used to evaluate the independent association between blood pressure and the risk of RVO development and identify differences between premenopausal and postmenopausal women.The incidence of RVO was higher among postmenopausal women than in premenopausal women. In the model adjusted for socioeconomic and clinical variables, there was an association between blood pressure and RVO development in premenopausal and postmenopausal women; however, this was stronger than premenopausal women.Both systolic and diastolic blood pressure are associated with an increased risk of RVO, and their effects are more potent in premenopausal women than postmenopausal women. Thus, comprehensive management of hypertension in premenopausal women is essential to reduce the risk of RVO.

Figure 1

Flow diagram showing the study design.

Figure 2

Adjusted hazard ratios of systolic blood pressure for RVO by menopause. The risk of RVO development in pre-menopausal women increased steadily with elevation of systolic blood pressure; however, it did not in post-menopausal women. The model was adjusted for age, sex, smoking status, alcohol consumption, body mass index, regular physical exercise, low income, diabetes mellitus, dyslipidemia, chronic kidney disease, and use of antihypertensive medication. MW = menopausal women, RVO = retinal vein occlusion.

Figure 3

Adjusted hazard ratios of diastolic blood pressure for RVO by menopause. The risk of RVO development in pre-menopausal women increased steadily with elevation of diastolic blood pressure; however, it did not in post-menopausal women. The model was adjusted for age, sex, smoking status, alcohol consumption, body mass index, regular physical exercise, low income, diabetes mellitus, dyslipidemia, chronic kidney disease, and use of antihypertensive medication. MW = menopausal women, RVO = retinal vein occlusion.