School of Medicine Publications and Presentations
Open-Angle Glaucomatous Optic Neuropathy Is Related to Dips Rather Than Increases in the Mean Arterial Pressure Over 24-H
Document Type
Article
Publication Date
8-1-2022
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 5 largest MAP dips/increases over 24-h, henceforth called dips/blips.
Methods: In the Maracaibo Aging Study (MAS), 93 participants aged ≥40 y (women, 87.1%; mean age, 61.9 y) 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 the MAS, 26 participants 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 mm Hg; -21.0 vs. -18.0 mm Hg 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, 1.36-8.46; P = 0.008). On top of covariables and 24-MAP level/variability, the dip measures increased the model performance (P ≤ 0.025). Blips did not associate with OAG. The case-control 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 24-h BP monitoring might be precautious steps required in normotensive and hypertensive patients at risk of OAG.
Recommended Citation
Melgarejo, J. D., Eijgen, J. V., Maestre, G. E., Al-Aswad, L. A., Thijs, L., Mena, L. J., Lee, J. H., Terwilliger, J. D., Petitto, M., Chávez, C. A., Brito, M., Calmon, G., Silva, E., Wei, D. M., Cutsforth, E., Keer, K. V., Gustavo De Moraes, C., Vanassche, T., Janssens, S., Stalmans, I., … Zhang, Z. Y. (2022). Open-Angle Glaucomatous Optic Neuropathy Is Related to Dips Rather Than Increases in the Mean Arterial Pressure Over 24-H. American journal of hypertension, 35(8), 703–714. 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
Comments
© The Author(s) 2022. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved.