Evidence map›Paper›PMID 27551956›Full record

SynthesisOphthalmic epidemiology2016

Topical Beta-Blockers and Cardiovascular Mortality: Systematic Review and Meta-Analysis with Data from the EPIC-Norfolk Cohort Study.

Claude Pinnock, Jennifer L Y Yip, Anthony P Khawaja, Robert Luben, Shabina Hayat, David C Broadway, Paul J Foster, Kay-Tee Khaw, Nick Wareham

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Ophthalmic epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Claude Pinnocka Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
Jennifer L Y Yipa Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
Anthony P Khawajaa Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
Robert Lubena Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
Shabina Hayata Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
David C Broadwayc Department of Ophthalmology , Norfolk and Norwich University Hospital , Norwich , UK.
Paul J Fosterb NIHR Biomedical Research Centre for Ophthalmology , Moorfields Eye Hospital and UCL Institute of Ophthalmology , London , UK.
Kay-Tee Khawa Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK.
Nick Warehamd MRC Epidemiology Unit , University of Cambridge School of Clinical Medicine , Cambridge , UK.

Funding

Cancer Research UK C864/A14136Department of HealthMedical Research Council G0401527Medical Research Council G1000143Medical Research Council MR/N003284/1Wellcome Trust
6 · The paper itself

Abstract

purposeTo determine if topical beta-blocker use is associated with increased cardiovascular mortality, particularly among people with self-reported glaucoma.

methodsAll participants who participated in the first health check (N = 25,639) of the European Prospective Investigation into Cancer (EPIC) Norfolk cohort (1993-2013) were included in this prospective cohort study, with a median follow-up of 17.0 years. We determined use of topical beta-blockers at baseline through a self-reported questionnaire and prescription check at the first clinical visit. Cardiovascular mortality was ascertained through data linkage with the Office for National Statistics mortality database. Hazard ratios (HRs) were estimated using multivariable Cox regression models. Meta-analysis of the present study's results together with other identified literature was performed using a random effects model.

resultsWe did not find an association between the use of topical beta-blockers and cardiovascular mortality (HR 0.93, 95% confidence interval, CI, 0.67-1.30). In the 514 participants with self-reported glaucoma, no association was found between the use of topical beta-blockers and cardiovascular mortality (HR 0.89, 95% CI 0.56-1.40). In the primary meta-analysis of four publications, there was no evidence of an association between the use of topical beta-blockers and cardiovascular mortality (pooled HR estimate 1.10, 95% CI 0.84-1.36).

conclusionTopical beta-blockers do not appear to be associated with excess cardiovascular mortality. This evidence does not indicate that a change in current practice is warranted, although clinicians should continue to assess individual patients and their cardiovascular risk prior to commencing topical beta-blockers.

Indexed as

Administration, TopicalAdrenergic beta-AntagonistsCardiovascular DiseasesGlaucomaHumansProportional Hazards ModelsProspective StudiesRisk FactorsAdrenergic beta-AntagonistsBeta-blockerscardiovascularepidemiologymortalitytopical

Identifiers

PMID27551956
PMCPMC5039398

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.