Open-Angle Glaucomatous Optic Neuropathy is Related to Dips Rather than Increases in the Mean Arterial Pressure Over 24-H

Authors

Jesus D. Melgarejo, The University of Texas Rio Grande ValleyFollow
Jan V. Eijgen
Gladys E. Maestre, The University of Texas Rio Grande ValleyFollow
Lama A. Al-Aswad, New York University School of Medicine
Lutgarde Thijs
Luis J. Mena
Joseph D. Terwilliger
Michele Petitto
Carlos A. Chavez
Miguel Brito

Document Type

Article

Publication Date

2-26-2022

Abstract

Background

Mean arterial pressure (MAP) drives ocular perfusion. Excessive 24-h MAP variability relates to glaucoma, however, whether this is due to dips or increases in the blood pressure (BP) is undocumented. We investigated the association of open-angle glaucoma (OAG) in relation to the five largest MAP dips/increases over 24-h, henceforth called dips/blips.

Methods

In the Maracaibo Aging Study (MAS), 93 participants aged ≥40y (women, 87.1%; mean age, 61.9y) underwent baseline ophthalmological and 24-h ambulatory BP monitoring assessments. OAG was the presence of optic nerve damage and visual field defects. Statistical methods included logistic regression and the generalized R2 statistic. For replication, 48 OAG cases at the Leuven Glaucoma Clinic were matched with 48 controls recruited from Flemish population.

Results

In MAS, 26 had OAG. OAG compared to non-OAG participants experienced longer and deeper dips (116.5 vs. 102.7 minutes; to 60.3 vs. 66.6 mmHg; 21.0 vs. 18.0 mmHg absolute or 0.79 vs. 0.81 relative dip compared to the preceding reading). The adjusted odds ratios associated with dip measures ranged from 2.25 (95% confidence interval [CI], 1.31-4.85; P=0.009) to 3.39 (95% CI, 1.368.46; P=0.008). On top of covariables and 24MAP level/variability, the dip measures increased the model performance (P≤0.025). Blips did not associate with OAG. The casecontrol study replicated the MAS observations.

Conclusions

Dips rather than increases in the 24-h MAP level were associated with increased risk for OAG. An ophthalmological examination combined with 24h BP monitoring might be precautious steps required in normotensive and hypertensive patients at risk of OAG.

Comments

© The Author(s) 2022. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Original published version available at https://doi.org/10.1093/ajh/hpac028

Recommended Citation

Jesus D Melgarejo, Jan V Eijgen, Gladys E Maestre, Lama A Al-Aswad, Lutgarde Thijs, Luis J Mena, Joseph H Lee, Joseph D Terwilliger, Michele Petitto, Carlos A Chávez, Miguel Brito, Gustavo Calmon, Egle Silva, Dong-Mei Wei, Ella Cutsforth, Karel V Keer, C Gustavo De Moraes, Thomas Vanassche, Stefan Janssens, Ingeborg Stalmans, Peter Verhamme, Jan A Staessen, Zhen-Yu Zhang, Open-Angle Glaucomatous Optic Neuropathy is Related to Dips Rather than Increases in the Mean Arterial Pressure Over 24-H, American Journal of Hypertension, 2022;, hpac028, https://doi.org/10.1093/ajh/hpac028

Publication Title

American Journal of Hypertension

DOI

10.1093/ajh/hpac028

Academic Level

faculty

Mentor/PI Department

Neuroscience