Nocturnal systemic hypotension increases the risk of glaucoma progression.
Nocturnal systemic hypotension increases the risk of glaucoma progression.
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DOI：
10.1016/j.ophtha.2014.04.016
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发表时间：
2014-10
期刊：
影响因子：
13.7
通讯作者：
Liebmann, Jeffrey M.
中科院分区：
文献类型：
--
作者：
Charlson, Mary E.;de Moraes, Carlos Gustavo;Link, Alissa;Wells, Martin T.;Harmon, Gregory;Peterson, Janey C.;Ritch, Robert;Liebmann, Jeffrey M.
这项对正常眼压性青光眼(NTG)患者的前瞻性纵向研究的目的是确定夜间低血压患者是否比夜间低血压患者在12个月内视野丧失(VF)的风险更大。前瞻性、纵向研究。对连续接受至少5次室颤试验的NTG患者进行资格筛选。基线评估评估了人口统计学和临床特征，涵盖了包括系统性高血压在内的全身并存情况。记录所有口服和眼科用药情况。在基线和随访时进行全面的眼科检查。患者在基线、6个月和12个月时用动态血压记录仪监测血压，每30分钟监测一次，持续48小时。主要结果是基于全球室颤进展速度，通过对平均室颤阈值敏感度随时间的线性回归(分贝/年)。纳入85例NTG患者(166只眼，平均年龄65岁，67%为女性)。在85名患者中，29%的患者在研究登记前收集的5个VFS中进展。比较夜间平均动脉压(MAP)和白天平均动脉压(MAP)。多变量分析显示，睡眠MAP低于日间MAP 10 mm Hg的总时间是VF进展的显著预测因素(P<；0.02)。在这个队列中，累积的夜间低血压可以预测室颤的丧失。我们的数据表明，夜间血压低于日间MAP的持续时间和幅度，特别是低于日间MAP 10毫米汞的血压，可以预测NTG的进展。夜间血压低，无论是自发发生的，还是药物治疗的结果，都可能导致室颤缺陷的恶化。
The objective of this prospective, longitudinal study of patients with normal-tension glaucoma (NTG) was to determine whether patients with nocturnal hypotension are at greater risk for visual field (VF) loss over 12 months than those without nocturnal hypotension. Prospective, longitudinal study. Consecutive patients with NTG with at least 5 prior VF tests were screened for eligibility. The baseline evaluation assessed demographic and clinical characteristics, covering systemic comorbid conditions, including systemic hypertension. All oral and ophthalmologic medications were recorded. A complete ophthalmological examination was performed at baseline and follow-up. Patients had their blood pressure (BP) monitored every 30 minutes for 48 hours with an ambulatory recording device at baseline and 6 and 12 months. The primary outcome was based on the global rates of VF progression by linear regression of the mean VF threshold sensitivity over time (decibels/year). Eighty-five patients with NTG (166 eyes; mean age, 65 years; 67% were women) were included. Of the 85 patients, 29% had progressed in the 5 VFs collected before study enrollment. The nocturnal mean arterial pressure (MAP) was compared with the daytime MAP. Multivariate analysis showed that the total time that sleep MAP was 10 mmHg below the daytime MAP was a significant predictor of subsequent VF progression (P<0.02). Cumulative nocturnal hypotension predicted VF loss in this cohort. Our data suggest that the duration and magnitude of decrease in nocturnal blood pressure below the daytime MAP, especially pressures that are 10 mmHg lower than daytime MAP, predict progression of NTG. Low nocturnal blood pressure, whether occurring spontaneously or as a result of medications, may lead to worsening of VF defects.
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影响因子：
5.1
作者：
Graham, SL;Drance, SM
通讯作者：
Drance, SM
影响因子：
4.2
作者：
HAYREH, SS;ZIMMERMAN, MB;ALWARD, WLM
通讯作者：
ALWARD, WLM
DOI：
10.1016/s0022-5223(95)70053-6
发表时间：
1995-11-01
影响因子：
6
作者：
GOLD, JP;CHARLSON, ME;ISOM, OW
通讯作者：
ISOM, OW
影响因子：
4.1
作者：
Fitzke, FW;Hitchings, RA;Crabb, DP
通讯作者：
Crabb, DP
影响因子：
4.2
作者：
KING, D;DRANCE, SM;WIJSMAN, K
通讯作者：
WIJSMAN, K