The role of 24-hour ambulatory blood pressure monitoring in hypertensive patients with normal-tension glaucoma

Abstract

Introduction. Extreme dippers are patients with a nocturnal fall of blood pressure (BP) of more than 20%, dippers have normal diurnal rhythm and decrease of BP of 10-15%, while patients with a nocturnal BP fall of less than 10% are considered to be non-dippers. Objective. The aim of this study was to compare 24-hour ambulatory BP monitoring results of normaltension glaucoma (NTG) patients with NTG suspects, as well as to determine whether NTG patients are more prone to daytime/nighttime systemic arterial BP and heart rate oscillations in comparison to NTG suspects. Methods. This was a prospective, cross-sectional and observational study of 57 hypertensive patients (39 female and 18 male), all examined at the Eye and the Cardiology Clinic, Clinical Center of Serbia in Belgrade, between November 2011 and March 2012. Before 24-hour ambulatory BP monitoring, complete ophthalmological examination was performed (intraocular pressure was measured with both Goldmann applanation and dynamic contour tonometer, as well as with computerized perimetry and Heidelberg retinal tomography). Results. There was no statistically significant difference between NTG patients and NTG suspects both in systolic daytime (131.86-141.81 mmHg, SD=?14.92 vs. 129.67-141.83 mmHg, SD=?13; p=0.53) and nighttime measurements (117.1-129.7 mmHg, SD=?18.96 vs. 112.11-127.59 mmHg, SD=?16.53; p=0.53) as well as diastolic daytime (74.55-80.37 mmHg, SD=?8.72 vs. 75.19-82.41 mmHg, SD=?7.72; p=0.58) and nighttime measurements (65.66-71.48 mmHg, SD=?8.73 vs. 67.12-73.78 mmHg, SD=?7.11; p=0.34). There was no statistically significant difference between NTG patients and NTG suspects in heart rate during the day (72.73-76.36 beats per minute [bpm], SD=?5.44 vs. 72.15-76.45 bpm, SD=?4.59; p=0.43) nor during the night (64.4-71.9 bpm, SD=?6.74 vs. 68.02-72.48 bpm, SD=?4.76; p=0.11). Conclusion. No statistically significant difference was found between NTG patients and NTG suspects in regard to their systolic and diastolic BP measured both during daytime and nighttime. NTG patients had lower nocturnal BP fall (both systolic and diastolic) than NTG suspects.