Higher risk of cardiovascular mortality linked with timolol

Cardiovascular mortality tends to increase in black persons with diagnosed and treated open-angle glaucoma (OAG) and ocular hypertension (OH), and the risk of death and cardiovascular mortality are increased further in those patients treated with timolol, according to a paper published in the March 11, 2008 issue of the Archives of Ophthalmology.

Suh-Yuh Wu of Stony Brook University, NY (US) and colleagues conducted the Barbados Eye Study in 4092 participants, who were predominantly black and were aged 40-84 years at baseline. At baseline, 300 participants had glaucoma, of whom 141 had been diagnosed and treated.

After nine years, 764 (19%) participants were deceased. Mortality was unrelated to overall OAG at baseline after adjustment for confounders. However, cardiovascular mortality tended to increase in persons with previously diagnosed/treated OAG (relative risk [RR], 1.38, p=0.07) and was significantly higher with treatment involving timolol maleate (RR, 1.91, p=0.04). Cardiovascular deaths also tended to increase in persons with OH at baseline (n=498; RR, 1.28, p=0.06).

The results led the study authors to conclude that cardiovascular mortality within this population tended to increase in persons with previously diagnosed/treated OAG and OH. The excess mortality was particularly significant in patients treated with timolol (60%) either alone or in combination, and thus warrants further investigation.