Low Diastolic Blood Pressure Is Associated with the Progression of Normal-Tension Glaucoma

Abstract

Aims: The objective of this study was to investigate the association between blood pressure (BP) and visual field defect progression in normal-tension glaucoma (NTG). Methods: The subjects were 35 consecutive patients with NTG who were admitted to Keio University Hospital for 24-hour intraocular pressure evaluation; all subjects underwent 6 or more visual field tests in either eye and were followed up for more than 5 years. Systolic and diastolic BPs were measured at 9.00 h. Subjects with negative regression lines and p values of less than 0.05 were classified as progressive; all others were defined as stable. Systolic BP, diastolic BP, and ocular perfusion pressure were compared between the 2 groups. Results: Twelve subjects showed progression in glaucomatous visual field defects (age 55.1 ± 15.1 years). Twenty-three subjects showed no progression (age 57.2 ± 10.9 years). Diastolic BP (stable group: 77.0 ± 12.1 mm Hg; progressive group: 67.7 ± 9.7 mm Hg; p = 0.03) was significantly lower in the progressive group than in the stable group. Multivariable analysis revealed that low diastolic BP is a significant risk factor for progression (OR 0.90; 95% CI 0.82–0.99). Conclusions: Low diastolic BP was associated with glaucomatous visual field progression in subjects with NTG.

Risk factors for open‐angle glaucoma with normal baseline intraocular pressure in a young population: the Korea National Health and Nutrition Examination Survey

“…Evidence for the effect of blood pressure on glaucoma remains controversial. Although there are some studies that showed relationship between low DBP, high SBP and low MOPP with a high prevalence of open-angle glaucoma 54 and low DBP with the progression of NTG, 55 other epidemiological studies failed to found significant association with hypertension and glaucoma. 13 As our study subjects consisted of adults under 40 years old, we presume that the relationship between blood pressure or ocular perfusion pressure and open-angle glaucoma with normal baseline IOP is not clear in this age group.…”

Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study

“…It is worthwhile noting that all these population-based studies only looked at IOP and BP parameters during daytime, unlike our study that looked at these parameters over a 24-h period. Okumura et al found that low diastolic BP was associated with glaucomatous VF progression in subjects with NTG [20].…”

The eye and the heart

“…It is a particularly well-established risk factor for glaucomatous optic neuropathy (GON). 45,46 As a consequence, blood pressure should not be lowered too rigorously in patients suffering from both systemic arterial hypertension and glaucoma. Spontaneous systemic hypotension [as it occurs particularly in the context of primary vascular dysregulation (PVD)] is very often observed in patients with normal tension glaucoma (NTG).…”