Nocturnal hypotension: Role in glaucoma progression
Nocturnal hypotension: Role in glaucoma progression
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DOI：
10.1016/s0039-6257(99)00016-8
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发表时间：
1999-06-01
影响因子：
5.1
通讯作者：
Drance, SM
中科院分区：
文献类型：
--
作者：
Graham, SL;Drance, SM
全身性血压在脑血管病损害中的作用尚不明确，不同的研究涉及全身性高血压和低血压。我们以前曾报道过，在一些进行性视野丧失的青光眼患者中，生理性夜间血压“下降”可能被夸大。最初对84例青光眼患者进行了24小时动态血压记录。所有青光眼患者的平均结果均在文献报道的正常受试者范围内。正常眼压性青光眼组和原发性开角型青光眼组在血压变量方面没有显著差异。与视野稳定的患者相比，进行性视野缺损患者的夜间血压变量较低。为了确定这些患者的长期结果，重新评估了最初研究的84名患者的视野。在70例具有长期视野数据（平均5.1年）的患者中，尽管眼内压控制良好，但夜间血压下降较大的患者更有可能在某个阶段显示视野进展。有视野进展的患者显示夜间血压变量显著较低，收缩压、舒张压和平均动脉压的下降幅度显著较大（收缩压下降，P = 0.01）。他们也有一个更大的磁盘存储历史。对文献中其他24小时血压研究的回顾表明，大多数与这些发现一致。因此，夜间血压降低可能是青光眼患者的另一个危险因素。(C)1999年，Elsevier Science Inc. All rights reserved.
The role of systemic blood pressure in glaucomatous damage remains undefined, with systemic hypertension and hypotension being implicated in different studies. We have previously reported that the physiologic nocturnal blood pressure "dip" may be exaggerated in some glaucoma patients with progressive field loss. A 24-hour ambulatory blood pressure recording was originally performed sri 84 patients with glaucoma. The mean result across all our glaucoma patients were within the ranges reported in the literature for normal subjects. The normal-tension glaucoma and primary open-angle glaucoma groups did not differ significantly in blood pressure variables. Nocturnal blood pressure variables were lower in the patients with progressive field defects compared to those with stable visual fields. To determine long-term outcomes in these patients, the reevaluated the visual fields of the original 84 patients studied. In 70 patients with long-term visual field data (mean, 5.1 years), those who had shown greater nocturnal blood pressure dips were more likely to have shown field progression at some stage, despite good intraocular pressure control. Patients who had field progression showed significantly lower nocturnal blood pressure variables, with the dips of the systolic, diastolic, and mean arterial pressure significantly larger (systolic dip, P = 0.01). They also had a greater history of disk hemorrhages. A review of other 24-hour blood pressure studies in the literature shows that most are in agreement with these findings. The nocturnal reduction in blood pressure may, therefore, be an additional risk factor in glaucoma patients. (C) 1999 by Elsevier Science Inc. All rights reserved.