Jesus D Melgarejo1,2, Jan V Eijgen3,4, Gladys E Maestre2,5,6,7, Lama A Al-Aswad8, Lutgarde Thijs1, Luis J Mena9, Joseph H Lee10,11, Joseph D Terwilliger12,13,14,15, Michele Petitto16, Carlos A Chávez2, Miguel Brito17, Gustavo Calmon18, Egle Silva18, Dong-Mei Wei1, Ella Cutsforth19, Karel V Keer3,4, C Gustavo De Moraes20, Thomas Vanassche21, Stefan Janssens22, Ingeborg Stalmans3,4, Peter Verhamme21, Jan A Staessen19,23, Zhen-Yu Zhang1. 1. Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. 2. Laboratory of Neurosciences, Faculty of Medicine, University of Zulia, Maracaibo, Zulia, Venezuela. 3. Department of Ophthalmology, University Hospitals UZ Leuven, Leuven, Belgium. 4. Department of Neurosciences, Research Group Ophthalmology, University of Leuven, Leuven, Belgium. 5. Rio Grande Valley Alzheimer's Disease Resource Center for Minority Aging Research (RGV AD-RCMAR), University of Texas Rio Grande Valley, Brownsville, Texas, USA. 6. Institute for Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, Texas, USA. 7. Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, Texas, USA. 8. Department of Ophthalmology, New York University (NYU) Grossman School of Medicine, NYU Langone Health, New York, New York, USA. 9. Department of Informatics, Universidad Politécnica de Sinaloa, Mazatlán, Mexico. 10. Taub Institute for Research in Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center, Columbia University Medical Center, New York, New York, USA. 11. Departments of Epidemiology and Neurology, Columbia University Medical Center, New York, New York, USA. 12. Department of Genetics and Development, Columbia University, New York, New York, USA. 13. Department of Psychiatry, G.H. Sergievsky Center, Columbia University, New York, New York, USA. 14. Division of Medical Genetics, New York State Psychiatric Institute, New York, New York, USA. 15. Division of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland. 16. Glaucoma and Retina Units, Eye Clinic of Maracaibo, Maracaibo, Zulia, Venezuela. 17. Instituto Docente de Especialidades Oftalmológicas (IDEO), Maracaibo, Zulia, Venezuela. 18. Laboratory of Ambulatory Recordings, Cardiovascular Institute (IECLUZ), University of Zulia, Maracaibo, Zulia, Venezuela. 19. Biomedical Science Group, Faculty of Medicine, University of Leuven, Leuven, Belgium. 20. Department of Ophthalmology, Columbia University, New York, New York, USA. 21. Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. 22. Division of Cardiology, Department of Internal Medicine, University Hospitals UZ Leuven, Leuven, Belgium. 23. Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium.
Abstract
BACKGROUND: Mean arterial pressure (MAP) drives ocular perfusion. Excessive 24-h MAP variability relates to glaucoma, however, whether this is due to dips or increases in the blood pressure (BP) is undocumented. We investigated the association of open-angle glaucoma (OAG) in relation to the 5 largest MAP dips/increases over 24-h, henceforth called dips/blips. METHODS: In the Maracaibo Aging Study (MAS), 93 participants aged ≥40 y (women, 87.1%; mean age, 61.9 y) underwent baseline ophthalmological and 24-h ambulatory BP monitoring assessments. OAG was the presence of optic nerve damage and visual field defects. Statistical methods included logistic regression and the generalized R2 statistic. For replication, 48 OAG cases at the Leuven Glaucoma Clinic were matched with 48 controls recruited from Flemish population. RESULTS: In the MAS, 26 participants had OAG. OAG compared to non-OAG participants experienced longer and deeper dips (116.5 vs. 102.7 minutes; to 60.3 vs. 66.6 mm Hg; -21.0 vs. -18.0 mm Hg absolute or 0.79 vs. 0.81 relative dip compared to the preceding reading). The adjusted odds ratios associated with dip measures ranged from 2.25 (95% confidence interval [CI], 1.31-4.85; P = 0.009) to 3.39 (95% CI, 1.36-8.46; P = 0.008). On top of covariables and 24-MAP level/variability, the dip measures increased the model performance (P ≤ 0.025). Blips did not associate with OAG. The case-control study replicated the MAS observations. CONCLUSIONS: Dips rather than increases in the 24-h MAP level were associated with increased risk for OAG. An ophthalmological examination combined with 24-h BP monitoring might be precautious steps required in normotensive and hypertensive patients at risk of OAG.
BACKGROUND: Mean arterial pressure (MAP) drives ocular perfusion. Excessive 24-h MAP variability relates to glaucoma, however, whether this is due to dips or increases in the blood pressure (BP) is undocumented. We investigated the association of open-angle glaucoma (OAG) in relation to the 5 largest MAP dips/increases over 24-h, henceforth called dips/blips. METHODS: In the Maracaibo Aging Study (MAS), 93 participants aged ≥40 y (women, 87.1%; mean age, 61.9 y) underwent baseline ophthalmological and 24-h ambulatory BP monitoring assessments. OAG was the presence of optic nerve damage and visual field defects. Statistical methods included logistic regression and the generalized R2 statistic. For replication, 48 OAG cases at the Leuven Glaucoma Clinic were matched with 48 controls recruited from Flemish population. RESULTS: In the MAS, 26 participants had OAG. OAG compared to non-OAG participants experienced longer and deeper dips (116.5 vs. 102.7 minutes; to 60.3 vs. 66.6 mm Hg; -21.0 vs. -18.0 mm Hg absolute or 0.79 vs. 0.81 relative dip compared to the preceding reading). The adjusted odds ratios associated with dip measures ranged from 2.25 (95% confidence interval [CI], 1.31-4.85; P = 0.009) to 3.39 (95% CI, 1.36-8.46; P = 0.008). On top of covariables and 24-MAP level/variability, the dip measures increased the model performance (P ≤ 0.025). Blips did not associate with OAG. The case-control study replicated the MAS observations. CONCLUSIONS: Dips rather than increases in the 24-h MAP level were associated with increased risk for OAG. An ophthalmological examination combined with 24-h BP monitoring might be precautious steps required in normotensive and hypertensive patients at risk of OAG.
Authors: Bryan Williams; Giuseppe Mancia; Wilko Spiering; Enrico Agabiti Rosei; Michel Azizi; Michel Burnier; Denis L Clement; Antonio Coca; Giovanni de Simone; Anna Dominiczak; Thomas Kahan; Felix Mahfoud; Josep Redon; Luis Ruilope; Alberto Zanchetti; Mary Kerins; Sverre E Kjeldsen; Reinhold Kreutz; Stephane Laurent; Gregory Y H Lip; Richard McManus; Krzysztof Narkiewicz; Frank Ruschitzka; Roland E Schmieder; Evgeny Shlyakhto; Costas Tsioufis; Victor Aboyans; Ileana Desormais Journal: Eur Heart J Date: 2018-09-01 Impact factor: 29.983
Authors: K Kashiwagi; O Hosaka; F Kashiwagi; K Taguchi; J Mochizuki; H Ishii; H Ijiri; K Tamura; S Tsukahara Journal: Jpn J Ophthalmol Date: 2001 Jul-Aug Impact factor: 2.447
Authors: William C Cushman; Gregory W Evans; Robert P Byington; David C Goff; Richard H Grimm; Jeffrey A Cutler; Denise G Simons-Morton; Jan N Basile; Marshall A Corson; Jeffrey L Probstfield; Lois Katz; Kevin A Peterson; William T Friedewald; John B Buse; J Thomas Bigger; Hertzel C Gerstein; Faramarz Ismail-Beigi Journal: N Engl J Med Date: 2010-03-14 Impact factor: 91.245
Authors: Tessa S Schoot; Mariska Weenk; Tom H van de Belt; Lucien J L P G Engelen; Harry van Goor; Sebastian J H Bredie Journal: J Med Internet Res Date: 2016-05-05 Impact factor: 5.428
Authors: Jesus D Melgarejo; Gladys E Maestre; Luis J Mena; Joseph H Lee; Michele Petitto; Carlos A Chávez; Gustavo Calmon; Egle Silva; Lutgarde Thijs; Lama A Al-Aswad; Joseph D Terwilliger; C Gustavo De Moraes; Fang-Fei Wei; Thomas Vanassche; Peter Verhamme; Jan A Staessen; Zhen-Yu Zhang Journal: Hypertens Res Date: 2021-07-12 Impact factor: 3.872