当前位置: X-MOL 学术Ophthalmology › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure
Ophthalmology ( IF 13.7 ) Pub Date : 2018-01-06 , DOI: 10.1016/j.ophtha.2017.11.029
Jesús D Melgarejo 1 , Joseph H Lee 2 , Michele Petitto 3 , Juan B Yépez 3 , Felipe A Murati 3 , Zhezhen Jin 4 , Carlos A Chávez 1 , Rosa V Pirela 1 , Gustavo E Calmón 5 , Winston Lee 6 , Matthew P Johnson 7 , Luis J Mena 8 , Lama A Al-Aswad 9 , Joseph D Terwilliger 10 , Rando Allikmets 11 , Gladys E Maestre 12 , C Gustavo De Moraes 6
Affiliation  

Purpose

To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics.

Design

Observational cross-sectional study.

Participants

A subset (n = 93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants, who were at least 40 years of age, had measurements for optical tomography coherence, visual field (VF) tests, 24-hour BP, office BP, and intraocular pressure <22 mmHg.

Methods

Univariate and multivariate logistic regression analyses under the generalized estimating equations (GEE) framework were used to examine the relationships between glaucomatous damage and BP parameters, with particular attention to decreases in nocturnal BP.

Main Outcome Measures

Glaucomatous optic neuropathy (GON) based on the presence of optic nerve damage and VF defects.

Results

The mean age was 61.9 years, and 87.1% were women. Of 185 eyes evaluated, 19 (26.5%) had signs of GON. Individuals with GON had significantly lower 24-hour and nighttime diastolic BP levels than those without. However, results of the multivariate GEE models indicated that the glaucomatous damage was not related to the average systolic or diastolic BP levels measured over 24 hours, daytime, or nighttime. In contrast, extreme decreases in nighttime systolic and diastolic BP (>20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio, 19.78 and 5.55, respectively).

Conclusions

In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme decreases in nocturnal BP in individuals at high risk of glaucoma are warranted.



中文翻译:

与夜间血压下降相关的青光眼性视神经病变

目的

确定哪些夜间血压 (BP) 参数(低水平或极端北斗星状态)与西班牙裔青光眼损伤风险增加有关。

设计

观察性横断面研究。

参与者

包括符合研究资格标准的马拉开波老龄化研究 (MAS) 参与者的子集 (n = 93)。这些至少 40 岁的参与者进行了光学断层扫描相干性、视野 (VF) 测试、24 小时血压、诊室血压和眼压 <22 mmHg 的测量。

方法

使用广义估计方程(GEE)框架下的单变量和多变量逻辑回归分析来检查青光眼损伤与血压参数之间的关系,特别注意夜间血压的降低。

主要观察指标

基于视神经损伤和 VF 缺陷的青光眼性视神经病变 (GON)。

结果

平均年龄为 61.9 岁,87.1% 为女性。在评估的 185 只眼中,19 只(26.5%)有 GON 的迹象。患有 GON 的个体的 24 小时和夜间舒张压水平显着低于未患 GON 的个体。然而,多变量 GEE 模型的结果表明,青光眼损伤与 24 小时、白天或夜间测量的平均收缩压或舒张压水平无关。相比之下,夜间收缩压和舒张压的极度下降(与白天 BP 相比 >20%)是青光眼损伤的重要危险因素(比值比分别为 19.78 和 5.55)。

结论

在这个人群中,夜间血压和 GON 之间的联系是由极端浸渍效应决定的,而不是单独的低夜间血压水平。考虑到青光眼高危人群夜间血压急剧下降的进一步研究是有必要的。

更新日期:2018-01-06
down
wechat
bug