Autonomic Dysfunction and Blood Pressure in Glaucoma Patients: The Lifelines Cohort Study.
Autonomic Dysfunction and Blood Pressure in Glaucoma Patients: The Lifelines Cohort Study.
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DOI：
10.1167/iovs.61.11.25
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发表时间：
2020-09-01
影响因子：
4.4
通讯作者：
Snieder H
中科院分区：
文献类型：
--
作者：
Asefa NG;Neustaeter A;Jansonius NM;Snieder H
我们研究了青光眼与自主神经功能障碍相关测量的关系，包括心率变异性（HRV）和血压（BP）。使用基于虹膜的算法对86，841名LifeLines队列研究参与者进行青光眼定义。根据静息心电图计算基线HRV（连续差异的均方根[RMSSD]）;收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和脉压（PP）是基于血流动力学的测量值。我们使用广义线性混合模型，校正年龄、年龄平方、性别、体重指数和家族关系，以评估基线HRV和BP（连续和四分位数）、高血压和抗高血压药物与青光眼的关系（中位数，3.8年）。青光眼的比值比（OR）为0.95（95%置信区间[CI]，0.92-0.99），对数转换的RMSSD（单位：ms）每增加一个单位，表明自主功能障碍（低HRV）与青光眼的高风险相关。血压每升高10 mm Hg，我们发现OR为1.03（95% CI，1.01-1.05; P = 0.015）SBP，1.01（95% CI，0.97-1.05; P = 0.55），MAP为1.03（95% CI，1.00-1.06; P = 0.083），PP为1.04（95% CI，1.01-1.07; P = 0.006）。最低与最高RMSSD四分位数的OR为1.15（95% CI，1.05-1.27; P = 0.003）。SBP和PP的最高四分位数与第二四分位数的OR分别为1.09（95% CI，0.99-1.19; P = 0.091）和1.13（95% CI，1.02-1.24; P = 0.015）。青光眼在高血压患者中更常见（OR，1.25; 95%CI，1.16-1.35; P < 0.001）;在使用血管紧张素转换酶（ACE）抑制剂的患者中，（OR，1.35; 95% CI，1.18-1.55; P < 0.001）;在使用钙通道阻滞剂的患者中（OR，1.19; 95% CI，1.01-1.40; P = 0.039）。低HRV、高SBP、高PP和高血压与青光眼相关。纵向研究可以阐明自主神经失调和高血压是否也能预测青光眼的发病率。
We investigated relationship of glaucoma with measurements related to autonomic dysfunction, including heart rate variability (HRV) and blood pressure (BP). Glaucoma was defined using a questionnaire-based algorithm for 86,841 LifeLines Cohort Study participants. Baseline HRV (root mean square of successive differences [RMSSD]) was calculated from resting electrocardiograms; systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) were oscillometric-based measurements. We used a generalized linear mixed model, adjusted for age, age square, sex, body mass index, and familial relationships to assess the relationship of baseline HRV and BP (continuous and quartiles), hypertension, and antihypertensive medication with glaucoma at follow up (median, 3.8 years). The odds ratio (OR) of glaucoma was 0.95 (95% confidence interval [CI], 0.92–0.99) per unit increase in log-transformed RMSSD (in ms), indicating that autonomous dysfunction (low HRV) is associated with a higher risk of glaucoma. Per 10-mm Hg increase in BP, we found ORs of 1.03 (95% CI, 1.01–1.05; P = 0.015) for SBP, 1.01 (95% CI, 0.97–1.05; P = 0.55) for DBP, 1.03 (95% CI, 1.00–1.06; P = 0.083) for MAP, and 1.04 (95% CI, 1.01–1.07; P = 0.006) for PP. The OR for the lowest versus highest RMSSD quartile was 1.15 (95% CI, 1.05–1.27; P = 0.003). The ORs for the highest versus second quartile were 1.09 (95% CI, 0.99–1.19; P = 0.091) for SBP and 1.13 (95% CI, 1.02–1.24; P = 0.015) for PP. Glaucoma was more common among hypertensives (OR, 1.25; 95% CI, 1.16–1.35; P < 0.001); among those using angiotensin-converting enzyme (ACE) inhibitors (OR, 1.35; 95% CI, 1.18–1.55; P < 0.001); and among those using calcium-channel blockers (OR, 1.19; 95% CI, 1.01–1.40; P = 0.039). Low HRV, high SBP, high PP, and hypertension were associated with glaucoma. Longitudinal studies may elucidate if autonomic dysregulation and high BP also predict glaucoma incidence.
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DOI：
10.1186/1878-5085-4-14
发表时间：
2013-06-07
期刊：
The EPMA journal
影响因子：
--
作者：
Flammer J;Konieczka K;Flammer AJ
通讯作者：
Flammer AJ
影响因子：
4.2
作者：
HAYREH, SS;ZIMMERMAN, MB;ALWARD, WLM
通讯作者：
ALWARD, WLM
影响因子：
13.7
作者：
Charlson, Mary E.;de Moraes, Carlos Gustavo;Link, Alissa;Wells, Martin T.;Harmon, Gregory;Peterson, Janey C.;Ritch, Robert;Liebmann, Jeffrey M.
通讯作者：
Liebmann, Jeffrey M.
影响因子：
3.7
作者：
Grieshaber, Matthias C;Flammer, Josef
通讯作者：
Flammer, Josef
DOI：
10.3129/i08-056
发表时间：
2008-06-01
影响因子：
4.2
作者：
Flammer, Josef;Mozaffarieh, Maneli
通讯作者：
Mozaffarieh, Maneli