Department of Ophthalmology, Nara Medical University School of Medicine, Nara, Japan.
Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
Hypertens Res. 2019 Feb;42(2):204-210. doi: 10.1038/s41440-018-0140-3. Epub 2018 Nov 21.
The present study aimed to determine the relationship between cataract subtypes and circadian blood pressure (BP) variability in elderly individuals. In this cross-sectional study of a community-based cohort, we assessed bilateral lens opacity using slit lamp photographs of 458 elderly individuals (mean age, 69.1 years). Cataract status was defined as a bilateral Lens Opacities Classification System III grade of ≥3 for nuclear cataract, ≥2 for cortical cataract, and ≥2 for posterior subcapsular cataract (PSC). Ambulatory BP monitoring was performed at 30-min intervals for 48 h. A nondipper pattern of BP was defined as a <10% decline in the mean nighttime systolic BP relative to the mean daytime systolic BP. The prevalence of nondipper patterns was 42.4% and 25.9% in the groups with nuclear cataracts (n = 66) and without cataracts for both eyes (n = 290), respectively. Multivariable logistic regression analysis adjusted for potential confounders revealed a significantly higher odds ratio (OR) for nondipper pattern in the group with nuclear cataract than in that without cataract (OR, 1.81; 95% confidence interval, 1.01-3.24; P = 0.047) but not in the group with cortical cataract (P = 0.61) or PSC (P = 0.95). In conclusion, circadian BP variability was significantly diminished in elderly individuals with nuclear cataracts but not in those with cortical cataracts or PSCs. These associations were independent of daytime light exposure, physical activity, and known risk factors of cataracts, such as aging, obesity, and diabetes.
本研究旨在探讨老年人群白内障亚型与昼夜血压（BP）变异性的关系。在这项基于社区的队列横断面研究中，我们使用 458 名老年患者（平均年龄 69.1 岁）的裂隙灯照片评估双侧晶状体混浊。白内障状态定义为双眼核性白内障的晶状体混浊分类系统 III 级≥3 级，皮质性白内障的≥2 级，后囊下白内障（PSC）的≥2 级。使用 30 分钟间隔的动态血压监测仪进行 48 小时监测。夜间收缩压平均下降<10%定义为非杓型血压模式。核性白内障组（n=66）和双眼无白内障组（n=290）的非杓型血压模式的患病率分别为 42.4%和 25.9%。多变量逻辑回归分析校正了潜在的混杂因素后显示，核性白内障组的非杓型血压模式的比值比（OR）显著高于无白内障组（OR，1.81；95%置信区间，1.01-3.24；P=0.047），但在皮质性白内障组（P=0.61）或 PSC 组（P=0.95）中则无显著差异。总之，昼夜血压变异性在核性白内障患者中显著降低，但在皮质性白内障或 PSC 患者中则无显著差异。这些关联独立于日间光照暴露、体力活动以及白内障的已知危险因素，如年龄、肥胖和糖尿病。
