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24 Hour Blood Pressure Monitoring in Normal Tension Glaucoma, Primary Open-angle Glaucoma and Healthy Controls

Daneljan L., Plange N., Kaup M., Remky A., Arend O.,
RWTH Aachen, Universitätsaugenklinik (Aachen)

Purpose: Both arterial hypertension and hypotension are known risc factors in glaucoma. In this study blood pressure was analysed in patients with normal tension glaucoma (NTG), primary open angle glaucoma (POAG) and healthy controls using 24 hour ambulatory blood pressure monitoring (ABPM).
Methods: We included 35 patients with NTG (13m, 22w, mean age 64 ±8 years), 26 patients with POAG (11m, 15w, mean age 65 ±11 years) and 15 controls (7m, 8w, mean age 53 ±17 years) in the study. ABPM (SpaceLabs Medical, Inc.) was performed monitoring systolic, diastolic and mean arterial blood pressure every 30 minutes during the day (8am to 8pm) and the night (0am to 6am). The standard deviation (SD) and coefficient of variation (CV) were calculated as parameters of blood pressure fluctuation. The nighttime blood pressure fall is given in percentage of mean blood pressure values of the day.
Results: Patients with glaucoma showed no significant difference in blood pressure fall at night compared to controls. Diastolic and mean blood pressure values were significantly higher during the day in NTG and during the night in NTG and POAG (p<0.05). No significant difference was found for systolic blood pressure and SD and CV during the day. Patients with NTG and patients with POAG had significant higher SD of the diastolic blood pressure values at night compared to the controls (p<0.05).
Conclusions: Patients with NTG and POAG have a higher variability of the diastolic blood pressure during the night and significantly higher diastolic and mean arterial blood pressure values compared to controls. Fluctuations of the diastolic blood pressure may play a role in glaucomatous optic neuropathy in NTG and POAG.