ARTERIAL-HYPOTENSION IN LOW OR MODERATELY ELEVATED INTRAOCULAR-PRESSURE GLAUCOMA PATIENTS

Background Arterial hypotension, by decreasing blood flow in the optic nerve head, may be a risk factor for glaucomatous damage. The purpose of this study was to compare blood pressure in different types of gla ucoma patients, using ambulatory recording. Methods An ambulatory bloo d pressure recording was performed in 55 glaucoma patients over a 24-h our period. Two groups of patients could have been differentiated acco rding to pretreatment intra-ocular pressure level: a group of 38 patie nts (GPNM) with normal or moderatly elevated intra-ocular pressure, an d a group of 17 patients (GPH) with high intra-ocular pressure. Result s A statistically significant different lower blood pressure was found in group GPNM for: diastolic mean blood pressure (76.4 versus 81.4 mm mHg p = 0.05), diastolic nocturnal (71.8 versus 78.1 mmHg p = 0.025), and for some hourly intervals: from 2:00 to 3:00 (p = 0.008), 8:00 to 9:00 (p = 0.01) and 15:00 to 18:00 (p = 0.03). The mean lowest reading s were lower (p < 0.05) in group GPNM (95.8/54,4 versus 102/59.9 mmHg) . The percentage of low readings (9.9% versus 5.1% p = 0.01) and systo lic drops (0.226 versus 0.192 p = 0.018) were also higher in this grou p. Conclusion Hypoperfusion of optic nerve head may be a significant f actor in glaucomatous damage by compromising blood supply. It is impor tant to identify arterial hypotension when examinating of normal or mo deratly elevated pressure glaucoma patients, and ambulatory monitoring of blood pressure is currently the best test. These episodes should b e taken into consideration, especially when initiating systemic antihy pertensive therapy, in order to maintain, as well as possible, perfusi on of the optic nerve head.