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N. Yildirim, H. Basmak, A. Sahin, Z. Ermis; The Effect of Sertraline on Ambulatory Blood Pressure and Ocular Perfusion Pressure in Normotensive Glaucoma Patients With Nocturnal Hypotension . Invest. Ophthalmol. Vis. Sci. 2006;47(13):484.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of sertraline on ambulatory blood pressure, and ocular perfusion pressure in normotensive glaucoma (NTG) patients with nocturnal hypotension.
A total of 12 NTG patients (6 females, 6 males) with nocturnal hypotension were enrolled. All patients underwent complete ophthalmologic examination and 24 hour ambulatory blood pressure monitoring. Patients were further classified as dipper and non–dipper according to difference between systolic and diastolic blood pressures. Ophthalmic artery flow rate was measured in daytime and nighttime by using Duplex ultrasonography. Ocular blood perfusion pressure (OBPP) was calculated using a special formula (OBPP=1/3*mean arterial pressure–IOP). 50 mg sertraline was given twice a day to all study patients for two months time. All measurements were performed respectively after 2 months later.
The mean patient age was 52.2 ± 11.4 years. Before sertraline treatment, mean systolic and diastolic blood pressure values in daytime were 122.0±11.9 and 75.6±7,0 mmHg, in nighttime were 98.8±7.9 and 60.8±5.9 mmHg, respectively. Daytime and nighttime difference was 23.2 mmHg in systole and 14.8 mmHg in diastole. Of the 12 patients, 7 patients have got over–dipper type blood pressure and 5 patients have got dipper type blood pressure. After 2 months sertraline treatment, mean systolic and diastolic blood pressure values in daytime were 116.2±11.7 and 73.4±7.6 mmHg, in nighttime were 107.3±11.2 and 65.6±7.9 mmHg, respectively. Daytime and nighttime difference was 8.9 mmHg in systole and 7.8 mmHg in diastole. Mean systolic blood pressure in daytime decreased significantly (t=2.42, p<0.05) with sertraline treatment but mean diastolic blood pressure did not change significantly (t=1.2, p<0.05). Mean systolic and diastolic blood pressure measured in nighttime increased significantly after sertraline treatment(t=–3.75 and t=–3.22, respectively. All p<0.01). Mean differences between systolic and diastolic blood pressures in daytime and nighttime decreased significantly (p<0.01). Ophthalmic artery flow rates OBPP, and IOP readings in daytime and nighttime did not change significantly with sertraline treatment.
Sertraline treatment improved nocturnal hypotension in NTG patients by decreasing the measured blood pressure difference between daytime and nighttime. However, no effect was observed on ophthalmic artery flow rate, OBPP, and IOP.
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