BLOOD PRESSURE CONTROL AND CIRCADIAN RHYTHM AMONG PATIENTS WITH PROGRESSIVE GLAUCOMA – PRELIMINARY RESULTS

Abstract

Objective: Blood pressure (BP) control, postural changes and daily variability in patients with progressive glaucoma. Design and method: The study included 55 patients with different duration of open-angle glaucoma who had disease progression during the visit qualifying for this observational study. During two separate visits with 7 to 14 days interval, an ophthalmological and the clinical examination (standardized questionnaire, three BP measurements, orthostatic test, 24hour ABPM) were performed. The criterion for hypertension (HT) control in treated patients aged 80 years and over was office BP <150/90 mmHg. Postural hypotension was defined as a drop in systolic BP (SBP) of at least 20 mmHg and/or a drop in diastolic BP (DBP) of at least 10 mmHg within 1, 3, or 5 minutes after standing. The validated devices were used to obtain BP measurements. Results: The mean age of patients was 69 years, most subjects were over 60 years of age; 40% were men, 75% were treated for hypertension (HT). ∗Data from ABPM are currently available for 39 patients. Patients with glaucoma progression noted in the short course of the disease (<5 years) were more likely to have uncontrolled HT in the office setting; in ABPM also had higher daytime SBP and greater daily SBP variability, although no statistical significance was observed. In turn, the oldest patients with long-term (>10 years) progressive glaucoma had too low nighttime SBP and DBP values. Conclusions: Conclusions. The results indicate an unfavorable prognostic impact of insufficient HT control and daily BP variability in people with a few years of glaucoma history. In the oldest patients, too low BP levels throughout the 24-hour period may contribute to its progression. Since most our patients had ABPM performed for the first time, emphasis should be placed on more frequent monitoring of circadian BP profile in glaucoma patients, especially among the oldest.