24-h blood pressure monitoring in normal tension glaucoma: night-time blood pressure variability

Primary Open-Angle Glaucoma vs Normal-Tension Glaucoma

“…Such findings suggest that a considerable overlap may exist in the development of POAG and NTG, especially in the early stages of the disease. The finding of so many comparable variables between our glaucoma groups is perhaps somewhat surprising, especially because, on the basis of previous research, 6,9,58 it was hypothesized that the evidence of vascular dysfunction would be more pronounced in NTG patients. The relative influence of IOP on the results obtained in this study is difficult to determine, and the possibility that the mechanisms by which these multiple vascular variables become similarly altered could still vary between glaucoma groups cannot be ruled out.…”

“…Increased variability in BP is widely recognized in cardiovascular and hypertension research as a signal of increased risk for end-organ damage 56 and, during recent years, its occurrence has been increasingly considered with regard to other vascular diseases, including glaucoma. [57][58][59] The mechanism by which such increased variability, during the nocturnal period in particular, may relate to the development of GON is unclear. It could be hypothesized that, because of the close relationship between BP and OPP, an increased variability in BP may subsequently lead to increased variability or fluctuation in OPP, which may have a particular effect nocturnally when OPP is already physiologically reduced and the optic nerve head is more vulnerable.…”

Sleep Apnea and Glaucoma – Greater Risk for Blacks?

“…Furthermore, clinical evidence suggests that continuous positive airway pressure treatment for sleep apnea results in a diminution of daytime and nighttime arterial blood pressure [80]. Concerning linkage between glaucoma and hypertension, studies have shown that patients with normal-tension glaucoma exhibited increased variability of night-time blood pressure compared with healthy controls [82]. This is important since increased fluctuation of blood pressure may lead to ocular reperfusion damage and may cause ischemic episodes at the optic nerve head.…”

“…Both sleep apnea and glaucoma are linked to hypertension [25,40,[79][80][81][82], which is more prevalent among Blacks (44% vs. 23%). based on a multi-site study of medically underserved patients [3].…”

“…Sleep apnea is widely recognized for its adverse vascular sequelae: acute myocardial infarction and/or nocturnal angina caused by arterial vasospasm [57]. These may be particularly harmful among patients with glaucoma because at night, ophthalmic artery flow velocities decrease commensurate with reductions in arterial blood pressure [82]. This is considered a vulnerable period when the risk of disease progression is heightened.…”