Topical beta‐blockers and the risk of cardiovascular mortality

Abstract

Purpose: Recently, the Blue Mountains Eye Study reported an association between the use of topical timolol and cardiovascular mortality (Lee et al. Ophthalmology 2006). The purpose of the present study was to confirm or falsify this clinically very important finding, using data from the population‐based Rotterdam Study. Methods: 6971 participants of the Rotterdam Study, a longitudinal population based study of all residents aged 55 years and older from a district of Rotterdam, The Netherlands, were followed from 1991 onwards. Medication use and morbidity were recorded continuously during follow‐up. For the current analysis, baseline use of topical beta‐blockers and systemic cardiovascular medication as well as baseline cardiovascular morbidity were used, aiming to follow the design of the Blue Mountains Eye Study as close as possible. Cause of death was registered up to 1‐1‐2005. Data were analysed using Cox regression; Hazard ratios of topical beta‐blocker use were adjusted for age, sex, cardiovascular morbidity and use of systemic cardiovascular medication. Results: Mean age at baseline was 69 years (SD 9 years); 146 participants were using topical beta‐blockers at baseline. 2726 participants died during follow‐up (all cause mortality 40.1%), 611 (9.0%) had a cardiovascular cause of death. Hazard ratio of topical beta‐blocker use was 0.80 (95% confidence interval 0.63‐1.02; P=0.07) for all cause mortality and 0.78 (0.46‐1.29; P=0.32) for cardiovascular mortality. Conclusions: In our data, the use of topical beta‐blockers at baseline was not associated with either all cause mortality or cardiovascular mortality during follow‐up.