Nocturnal blood pressure in primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Cardiology
• Nephrology

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Nocturnal blood pressure (BP) dipping is a physiological phenomenon with implications for cardiovascular health.
• The relationship between BP dipping patterns and glaucoma severity remains incompletely understood.

Purpose of the Study:

• To investigate the nocturnal BP dipping patterns in patients diagnosed with POAG.
• To explore potential associations between these BP dipping patterns and the extent of visual field damage in POAG patients.

Main Methods:

• A cross-sectional study involving 314 POAG patients.
• Utilized 24-hour ambulatory BP monitoring and Humphrey 30-2 computerized perimetry.
• Defined dipping categories based on the night-day BP ratio: non-dipping (<10%), physiological dipping (10-20%), and over-dipping (>20%).

Main Results:

• POAG patients with daytime normotension and over-dipping patterns exhibited significantly greater visual field loss (MD = -16.6 dB) compared to those with hypertension (MD = -3.9 dB).
• This association remained significant after adjusting for covariates including age, glaucoma duration, and medication.
• A p-value of 0.004 indicated a statistically significant difference between groups.

Conclusions:

• Nocturnal BP status should be interpreted in the context of daytime BP levels for individual POAG patients.
• 24-hour BP monitoring may be a valuable tool for assessing POAG risk and progression.
• Nocturnal BP patterns could represent a modifiable risk factor influencing glaucoma severity.