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.

CONCLUSION

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.