The effect of antihypertensive therapy on dry eye disease

Abstract

Context: There is a generalization that “antihypertensive (antiHT) therapy causes Dry Eye Syndrome”, which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function.

Objective: The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms.

Materials and methods: Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic −). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB −) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month.

Results: The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0–1st month) and the third month (0–3rd months) control measurements between diuretics (+) and diuretics (−) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0–1st month measurements of ACE/ARB (+) and ACE/ARB (−) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022).

Discussion and conclusion: The use of antiHT drugs containing diuretic had no adverse effect on the tear function tests, but using drugs that contain ACE/ARB could have a positive impact.

• Antihypertension medicals
• dry eye
• tear osmolarity

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.