Diurnal and nocturnal blood pressure drops in patients with focal ischemic glaucoma.
BACKGROUND
The purpose of this study was to assess the role of arterial hypotension in the pathogenesis of certain types of glaucoma.


METHODS
We compared diurnal and nocturnal fluctuations in blood pressure by using an ambulatory recording over a 24-h period in two different groups of patients: one of 16 patients with focal ischemic glaucoma (FIG) and another of 16 patients with primary open angle glaucoma (POAG).


RESULTS
In patients with FIG, compared to those with POAG, we found: lower diastolic blood pressure (BP; 75.7 vs 82.5 mmHg, P < 0.05), systolic BP (121.7 vs 131.2 mmHg, P < 0.05) and mean BP (90.5 vs 101.5 mmHg, P < 0.05) over 24 h; lower diurnal diastolic BP (78.1 vs 85.5 mmHg, P < 0.05), and systolic BP (124.6 vs 134.2 mmHg, P < 0.05); greater nocturnal systolic BP variability (8.2% vs 6.2%, P < 0.05); and a greater percentage of diurnal low readings (14.53% vs 2.8%, P < 0.05), compared with the literature limits (101/61 mmHg). However, the number of nocturnal low readings was not different for either group.


CONCLUSIONS
It is important to detect arterial hypotension - one of the components of the vascular factor - during examination of a patient with normal-pressure glaucoma. This is one element in preserving the best possible perfusion of the optic nerve.
Department of Ophthalmology, CHU Angers, France.
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Béchetoille
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Bresson-Dumont
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D005654:Fundus Oculi; D005901:Glaucoma / Q000503:physiopathology*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000503:physiopathology*; D007511:Ischemia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009898:Optic Disk / Q000098:blood supply*; D014794:Visual Fields