Effect of 24-h blood pressure dysregulations and reduced ocular perfusion pressure in open-angle glaucoma progression.

Autor: Melgarejo JD; Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.; Institute of Neurosciences, School of Medicine, University of Rio Grande Valley, Harlingen.; Rio Grande Valley Alzheimer's Disease Resource Center for Minority Aging Research (RGV AD-RCMAR), University of Texas Rio Grande Valley, Brownsville, Texas, USA., Van Eijgen J; Department of Ophthalmology, UZ Leuven.; Department of Neurosciences, Research Group Ophthalmology, KU Leuven, Leuven, Belgium., Wei D; Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium., Maestre GE; Institute of Neurosciences, School of Medicine, University of Rio Grande Valley, Harlingen.; Rio Grande Valley Alzheimer's Disease Resource Center for Minority Aging Research (RGV AD-RCMAR), University of Texas Rio Grande Valley, Brownsville, Texas, USA.; Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, Texas., Al-Aswad LA; Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Liao CT; Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium., Mena LJ; Department of Informatics, Universidad Politécnica de Sinaloa, Mazatlán, México., Vanassche T; Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven., Janssens S; Division of Cardiology, Department of Internal Medicine, UZ Leuven, Leuven, Belgium., Verhamme P; Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, KU Leuven., Zhang ZY; Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium., Van Keer K; Department of Ophthalmology, UZ Leuven.; Department of Neurosciences, Research Group Ophthalmology, KU Leuven, Leuven, Belgium., Stalmans I; Department of Ophthalmology, UZ Leuven.; Department of Neurosciences, Research Group Ophthalmology, KU Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: Journal of hypertension [J Hypertens] 2023 Nov 01; Vol. 41 (11), pp. 1785-1792. Date of Electronic Publication: 2023 Sep 11.
DOI: 10.1097/HJH.0000000000003537
Abstrakt: Background: Low ocular perfusion pressure (OPP), which depends on the mean arterial pressure (MAP) and intraocular pressure (IOP), is associated with glaucoma. We studied 24-h MAP dysregulations and OPP in relation to the progression of glaucoma damage.
Methods: We retrospectively analyzed 155 normal-tension glaucoma (NTG) and 110 primary open-angle glaucoma (POAG) patients aged 18 years old followed at the University Hospital Leuven with repeated visual field tests ( n  = 7000 measures, including both eyes) who underwent 24-h ambulatory blood pressure monitoring. Twenty-four-hour MAP dysregulations were variability independent of the mean (VIM), and the five lowest dips in MAP readings over 24 h. OPP was the difference between 2/3 of the MAP and IOP. Glaucoma progression was the deterioration of the visual field, expressed as decibel (dB) changes in mean deviation analyzed by applying multivariable linear mixed regression models.
Results: The mean age was 68 years (53% were women). High 24-h VIMmap was associated with glaucoma progression in POAG ( P  < 0.001) independently of the 24-h MAP level. The estimated changes in mean deviation in relation to dip MAP measures ranged from -2.84 dB [95% confidence interval (CI) -4.12 to -1.57] to -2.16 dB (95% CI -3.46 to -0.85) in POAG. Reduced OPP along with high variability and dips in MAP resulted in worse mean deviation deterioration.
Conclusion: The progression of glaucoma damage associates with repetitive and extreme dips in MAP caused by high variability in MAP throughout 24 h. This progression exacerbates if 24-h MAP dysregulations occur along with reduced OPP.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze: MEDLINE
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