@article {1328908,
	title = {Racial Differences in the Effects of Hormone Therapy on Incident Open-Angle Glaucoma in a Randomized Trial},
	journal = {Am J Ophthalmol},
	volume = {195},
	year = {2018},
	month = {2018 Nov},
	pages = {110-120},
	abstract = {PURPOSE: We conducted a secondary analysis of a randomized, placebo-controlled trial to test if hormone therapy (HT) altered the risk of open-angle glaucoma (OAG), and if the risk reduction varied by race. DESIGN: Secondary analysis of randomized controlled trial data. METHODS: We linked Medicare claims data to 25 535 women in the Women{\textquoteright}s Health Initiative. Women without a uterus were randomized to receive either oral conjugated equine estrogens (CEE 0.625\&nbsp;mg/day) or placebo, and women with a uterus received oral CEE and medroxyprogesterone acetate (CEE 0.625\&nbsp;mg/day\&nbsp;+ MPA 2.5\&nbsp;mg/day) or placebo. We used Cox proportional hazards models to calculate hazard ratios (HR) and 95\% confidence interval. RESULTS: After exclusion of women with prevalent glaucoma or without claims for eye care provider visits, the final analysis included 8102 women (mean age\&nbsp;= 68.5 {\textpm} 4.8 years). The OAG incidence was 7.6\% (mean follow-up\&nbsp;= 11.5 {\textpm} 5.2 years; mean HT duration\&nbsp;= 4.4 {\textpm} 2.3 years). Increased age (P trend\&nbsp;= .01) and African-American race (HR\&nbsp;= 2.69, 95\% CI\&nbsp;= 2.13-3.42; white as a reference) were significant risk factors for incident OAG. We found no overall benefit of HT in reducing incident OAG (HR\&nbsp;= 1.01, 95\% CI\&nbsp;= 0.79-1.29 in the CEE trial, and HR\&nbsp;= 1.05, 95\% CI\&nbsp;= 0.85-1.29 in the CEE\&nbsp;+ MPA trial). However, race modified the relationship between CEE use and OAG risk (P interaction\&nbsp;= .01), and risk was reduced in African-American women treated with CEE (HR\&nbsp;= 0.49, 95\% CI\&nbsp;= 0.27-0.88), compared to placebo. Race did not modify the relation between CEE\&nbsp;+ MPA use and OAG risk (P interaction\&nbsp;= .68). CONCLUSIONS: Analysis suggests that HT containing estrogen, but not a combination of estrogen and progesterone, reduces the risk of incident OAG among African-American women. Further investigation is needed.},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2018.07.035},
	author = {Vajaranant, Thasarat Sutabutr and Ray, Roberta M and Pasquale, Louis R and Mares, Julie A and Ritch, Robert and Gower, Emily W and Haan, Mary N and Jackson, Rebecca D and Maki, Pauline M}
}
