Objective. The prevalence of celiac disease (CD) as recorded in the Danish National Patient Registry is ∼50/100,000 persons. This is much lower than the reported prevalence of CD in other Nordic countries and underdiagnosis is suspected. Our aim was to estimate the prevalence of CD in a population-based study of Danish adults. Methods. A total of 2297 adults aged 24–76 years living in the southwestern part of Copenhagen were screened for CD by immunoglobulin (Ig)A and IgG antibodies to transglutaminases and deamidated gliadin. IgA/IgG-positive participants were invited to a clinical evaluation, including biopsies, by a gastroenterologist. Results. Of the invited 56 participants, 40 underwent a full clinical evaluation and 8 persons were diagnosed with CD; 2 of the 16 persons, who did not complete the clinical evaluation, were considered by experts to have probable CD. None of the above 56 participants had a known history of CD or a recorded diagnosis of CD in National Patient Registry. By combining cases of biopsy-proven CD (n = 8), probable CD (n = 2), and registry-recorded CD (n = 1), the prevalence of CD was estimated to be 479/100,000 (11/2297) persons (95% CI: 197–761). Conclusion. In this general adult population, the prevalence of CD as estimated by screening and clinical evaluation was 10 times higher than the registry-based prevalence of CD. Of 11 participants diagnosed with CD in our screening study, 10 were unaware of the diagnosis prior to the study. Thus, our study suggests that CD is markedly underdiagnosed in Danish adults.
PurposeThe purpose of the present study was to describe the prevalence, incidence and geographic variation of glaucoma in Denmark in the period from 1996 to 2011. Moreover, the aim was to identify the treatment patterns of glaucoma within the studied period.MethodsAll Danish citizens were included throughout the study period. The National Prescription Registry was used to identify all claimed prescriptions for glaucoma medication.ResultsA total of 116,592 incident glaucoma patients were identified. Average age at onset was 66 years (range: 0–105 years), 55% were women. The prevalence of glaucoma increased from 0.79% to 1.72% during the investigated period. In 2011 glaucoma affected 3.76% of the population above 50 years and 10% in patients above 80 years. The age-specific incidence rate of glaucoma seemed to be constant and the increasing prevalence was primarily attributed to an aging population. We found the highest prevalence of glaucoma in the capital region of Denmark. Within the studied period the use of prostaglandin analogs and combination drugs increased, whereas the use of β-blockers, carbon anhydrase inhibitors and parasympathomimetic drugs decreased (p<0.001). Finally, the use of α2-adrenergic agonists remained unchanged. A total of 75% of the patients were treated with two or more glaucoma medications.ConclusionsOver all, the present study is the first to assess the frequency and the development of glaucoma in Denmark over a 15-year period. We find that glaucoma affects a little less than 2% of the total population and increases with age to reach a prevalence of more than 10% amongst people above 80 years. Generally, the present study is the largest nation-wide study ever made and must be a close-to-real-life-picture of the utilization of glaucoma medication on a national scale. Our findings confirm other recent estimations on an increasing burden of glaucoma globally.
G laucoma is the second most common irreversible cause of blindness worldwide.1 It is becoming increasingly important in the context of an aging world population.1,2 It possesses a considerable challenge to public health because blindness and visual impairment is costly and have a huge impact on life quality. 3 Raised intraocular pressure (IOP) remains the only successful treatable factor to reduce the progression of glaucoma. Yet, glaucoma is multifactorial, and the understanding of the pathology is incomplete. More than 2 decades ago, the first study to suggest that blood pressure (BP) should be considered in glaucoma treatment was published. 4 Since then, the impact of BP on glaucoma has received greater attention as more evidence has mounted. [5][6][7] Despite the increasing evidence of an association between BP and glaucoma, the exact relationship is complex. In this matter, epidemiological and case-control studies have shown diverse results, and some studies have presented evidence of a correlation between high BP and glaucoma, [5][6][7][8][9][10][11] whereas other studies have linked glaucoma and low-tension glaucoma with low BP.12-17 The controversies have been discussed and related to the complexity of BP not only influencing IOP and ocular perfusion pressure, but also increasing the risk of compromised peripheral vascular capacity and a dysfunctional autoregulation. 5,[17][18][19] Recognized high BP is treated with many different antihypertensive medications, and growing evidence acknowledges that such treatment is associated with glaucoma. [20][21][22] In this matter, antihypertensive medication may conflict with ocular perfusion and autoregulation. 20,23 Although studies have shown a correlation between antihypertensive treatment and glaucoma, these studies have mostly been trials in small numbers of patients with minimal follow-up periods. 1,14,24 Moreover, to the best of our knowledge, no previous study has benefited from a complete data sample from an entire population norimportantly-estimated the causal effect of antihypertensive treatment on the risk of developing glaucoma.The main outcome in our study is the treatment for glaucoma. We hypothesized, before embarking on the empirical analysis, that treatment with antihypertensive medication could have an ambiguous effect on the development Abstract-The aim was to investigate the impact of antihypertensive medication on the onset of glaucoma. Data from the complete Danish population between 40 and 95 years of age were used in the period from 1996 to 2012, covering >2.6 million individuals. The National Danish Registry of Medicinal Products Statistics was used to identify all claimed prescriptions for glaucoma medication and antihypertensive drugs. We first investigated basic correlations in the data and found that patients treated with antihypertensive medication, at any time during the study period, had a significantly higher overall relative risk (RR) of glaucoma, even when controlling for age and sex (with a RR of 1.31 and P<0.0001). Furthermor...
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