Normal-tension glaucomatous optic neuropathy is related to blood pressure variability in the Maracaibo Aging Study
Open accessAbstract
Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIM map). Odds ratios (ORs) were adjusted for 24-h MAP level and for a propensity score of up to five risk factors. Among the 93 participants (87.1% women; mean age, 61.9 years), 26 had open-angle normal-tension GON at both eyes; 14 had visual field defects; and 19 did not have visual field defects. The OR ratios for normal-tension GON, expressed per 1-SD increment in VIM map (2 mm Hg), were 2.17 (95% confidence interval, 1.33-3.53) unadjusted; 2.20 (1.35-3.61) adjusted for 24-h MAP level only; 1.93 (1.10-3.41) with additional adjustment for age, educational attainment, high-density lipoprotein (HDL) cholesterol and office hypertension; and 1.95 (1.10-3.45) in models including intraocular pressure. We confirmed our a priori hypothesis that BP variability, most likely operating via hypoperfusion of the optic nerve, is associated with normal-tension GON. 24-H ambulatory BP monitoring might therefore help stratify the risk of normal-tension GON.
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Even in patients without hypertension, BP variability is associated with glaucomatous optic neuropathy, most probably through hypoperfusion of the optic nerve.
“Furthermore, even in patients without hypertension, BPV has been associated with glaucomatous optic neuropathy, most probably via hypoperfusion of the optic nerve84.”
From Blood pressure and its variability: classic and novel measurement techniques (2022) · cites this paper as [84]
The Abstract and Discussion report an association between blood-pressure variability and normal-tension glaucomatous optic neuropathy, with optic-nerve hypoperfusion proposed as the likely mechanism. But “normal-tension” refers to intraocular pressure, not the absence of hypertension. The Results report that office hypertension was common and do not establish the association specifically in participants without hypertension. (LLM, conf=0.90)
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- Authors
- Melgarejo, J. D., Maestre, G. E., Mena, L. J., Lee, J. H., Petitto, M., Chávez, C. A., Calmon, G., Silva, E., Thijs, L., Al-Aswad, L. A., Terwilliger, J. D., De Moraes, C. G., Wei, F.-F., Vanassche, T., Verhamme, P., Staessen, J. A., & Zhang, Z.-Y.
- Affiliations
- Universidad del Zulia (VE)
- Universidad Politécnica de Sinaloa (MX)
- Columbia University Irving Medical Center (US)
- Hospital Universitario de Maracaibo (VE)
- KU Leuven (BE)
- Finnish Institute for Health and Welfare (FI)
- Maastricht University (NL)
- Corresponding author
- Zhang, Zhen-Yu
- ORCID
- Venue
- Hypertension Research
- Published
- 2021-07-12
- Volume
- 44
- Issue
- 9
- Pages
- 1105-1112
- ISSN
- 0916-9636 (ISSN-L)
- 1348-4214
- PMC
- PMC8429242
- OpenAlex
- W3181313351
- Cited by
- 11
- References
- 32
- Citations by year
- 2024: 5 · 2023: 3 · 2022: 3
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension Research (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ScholarWorks @ UTRGV (The University of Texas Rio Grande Valley) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG036469, P30AG059305, P30AG066546)
- National Eye Institute (R21EY029605)
- Topics
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- blood pressure variability, mean arterial pressure, ambulatory blood pressure monitoring, visual field defects, open-angle glaucoma
- MeSH terms
- Aging, Blood Pressure, Cross-Sectional Studies, Female, Glaucoma, Humans, Male, Middle Aged, Optic Nerve, Optic Nerve Diseases
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