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R.E. P. Frenkel, A.R. Toler, J. Mucciolo; Blood Pressure Parameters in Patients with Normal Tension Glaucoma and Systemic Hypertension . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4435.
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© ARVO (1962-2015); The Authors (2016-present)
Introduction: Patients with normal tension glaucoma (NTG) and a positive cardiovascular history, including hypertension, do not benefit from IOP lowering.1 We performed 24–hour ambulatory blood pressure monitoring (ABPM) on 28 NTG patients to determine whether patients with NTG and systemic hypertension (HTN) manifest blood pressure abnormalities that are not present in NTG patients without HTN. Methods: 16 NTG patients with HTN on treatment were compared to 12 NTG patients without HTN. All patients had 24–hour ABPM. Mean systolic dips (MSD) and mean diastolic dips (MDD) were calculated, as well as the diastolic perfusion pressures (DPP) to each eye. Additionally, we evaluated nocturnal systolic dips (NSD) and nocturnal diastolic dips (NDD) that occurred only during the nocturnal phase (intra–phase evaluation) relative to other higher nocturnal measurements, and similar daytime systolic dips (DSD) and daytime diastolic dips (DDD) that occurred only during the daytime phase. Results: For the (NTG with HTN) and (NTG without HTN) groups respectively–– MSD: 6.31 ± 14.3, 7.1 ± 10, p=0.43; MDD: 14.4 ±13.5, 12.3 ± 14.6, p=0 .35; DPP, O.D.: 60 ± 9.47, 56.6 ± 6.53, p= 0.13; DPP, O.S.: 60.2 ± 10.2, 56.8 ± 6.4, p= 0.15; NSD: 21 ± 7.8, 18.7 ± 5.76, p= 0.2; NDD: 28.7 ± 8.4, 23.7 ± 8.04, p= 0.06; DSD: 23.6 ± 11.8, 19.8 ± 7.22, p=0.16; DDD: 27 ± 9.2, 26.3± 6, p= 0.4. Discussion: There was no statistically significant difference in systemic blood pressure parameters in NTG patients with HTN compared to those without. Conclusion: Though systemic blood pressure abnormalities in NTG patients with HTN were detected, they were not statistically different from those in patients without HTN. Other cardiovascular etiologies may be responsible for the poor response to IOP lowering in these patients. References: Anderson DA et al. Factors that predict the benefit of lowering intraocular pressure in normal–tension glaucoma. Am J Ophthalmol 2003; 136:1820–29, 2003.
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