A marked fall in nocturnal blood pressure is associated with the stage of primary open-angle glaucoma in patients with arterial hypertension

Figures & data

Table I. The results of ophthalmological examination for the whole group of patients and the comparison of parameters analyzed in the ophthalmological examination between groups, depending on the level of blood pressure fall at night.

	Group 1, NBPF<10%	Group 2, NBPF 10–15%	Group 3, NBPF >15%	Anova or Kruskal–Wallis test, p	Bonferroni or Dunn's correction, p
Number of patients	35	15	19
Age (years)	60.02 ± 14.5	51.33 ± 12.21	49.79 ± 18.95	0.069
IOPd (mmHg)	15.82 ± 2.71	17.06 ± 2.52	16.94 ± 2.29	0.157
IOPn (mmHg)	15.88 ± 2.72	17.06 ± 2.52	16.84 ± 2.52	0.180
OPPd (mmHg)	47.3 ± 7.0	46.1 ± 6.51	48.7 ± 5.62	0.498
OPPn (mmHg)	42.8 ± 6.9	37.5 ± 6.77	36.22 ± 5.33	0.0009	0.002*
					0.026**
RNFL (μm)	129.72 ± 20.86	110.82 ± 28.76	106.08 ± 28.8	0.065
VFD (%)	24.28 ± 14.15	35.66 ± 16.57	49.73 ± 13.69	<0.0001	0.000003*
VEP A (mV)	9.82 ± 4.18	6.29 ± 3.87	7.27 ± 5.65	0.025	0.046**
VEP L (m/s)	117.24 ± 10.26	125.73 ± 11.19	130.73 ± 10.55	0.0002	0.0002*
					0.032**

*Comparison between Groups 1 and 3; **comparison between Groups 1 and 2; ***comparison between Groups 2 and 3. IOPd, mean intraocular pressure during the day; IOPn, mean intraocular pressure at night; OPPd, ocular perfusion pressure during the day; OPPn, ocular perfusion pressure at night; RNFL, retinal nerve fiber layer thickness; VFD, visual field defect; VEP A, visual evoked potentials, amplitude; VEP L, visual evoked potentials, latency.

Table II. Comparison of analyzed parameters of flow in the retrobulbar vessels between the groups, depending on the level of night blood pressure fall.

	Group 1, NBPF<10%	Group 2, NBPF 10–15%	Group 3, NBPF >15%	Anova or Kruskal–Wallis test, p	Bonferroni or Dunn's correction, p
OA-PSV (cm/s)	33.38 ± 8.89	28.38 ± 8.83	18.56 ± 7.72	<0.0001	0.000005*
					0.039
OA-EDV (cm/s)	11.22 ± 3.93	8.24 ± 5.15	3.71 ± 2.41	<0.0001	<0.000001*
					0. 368**
					0.009***
OA-RI	0.68 ± 0.16	0.74 ± 0.22	0.89 ± 0.06	<0.0001	0.000001*
					0.042***
CRA-PSV (cm/s)	13.93 ± 3.46	11.75 ± 3.93	9.09 ± 2.83	0.0001	0.00004*
CRA-EDV (cm/s)	5.96 ± 1.38	4.16 ± 1.51	2.96 ± 1.18	<0.0001	<0.000001*
					0.003**
					0. 283***
CRA-RI	0.58 ± 0.09	0.67 ±0.11	0.73 ±0.11	0.0002	0.0002*
SPCA-PSV (cm/s)	10.9 ± 2.34	10.01 ± 1.69	10.7 ± 1.72	0.065
SPCA-EDV (cm/s)	5.13 ± 1.33	5.17 ± 2.14	4.42 ± 1.58	0.124
SPCA-RI	0.55 ± 0.15	0.51 ± 0.19	0.55 ±0.16	0.759

* Comparison between Groups 1 and 3; **comparison between Groups 1 and 2; ***comparison between Groups 2 and 3.

OA-PSV, ophthalmic artery peak systolic velocity; OA-EDV, ophthalmic artery end-diastolic velocity; OA-RI, ophthalmic artery vascular resistance index; CRA-PSV, central retinal artery peak systolic velocity; CRA-EDV, central retinal artery end-diastolic velocity; CRA-RI, central retinal artery resistance index; SPCA-PSV, short posterior ciliary arteries peak systolic velocity; SPCA-EDV, short posterior ciliary arteries end-diastolic velocity; SPCA-RI, short posterior ciliary arteries resistance index.

Table III. Comparison of blood pressure values between the groups set during ambulatory blood pressure monitoring (ABPM), depending on the level of night blood pressure fall.

	Group 1 (NBPF<10%)	Group 2 (NBPF 10–15%)	Group 3 (NBPF >15%)	Anova or Kruskal–Wallis test, p	Bonferroni or Dunn's correction, p
Mean SBP (mmHg)	130.2 ± 12.0	125.13 ± 11.26	127.05 ± 10.41	0.316
Mean DBP (mmHg)	77.41 ± 7.44	75.33 ± 5.08	77.0 ± 6.5	0.609
SBP min (mmHg)	94.23 ± 12.54	85.33 ± 10.65	85.18 ± 9.46	0.005	0.013*
DBP min (mmHg)	52.65 ± 7.72	45.8 ± 4.87	43 ± 2.53	<0.0001	0.000005*
					0.020**
MAPd (mmHg)	94.65 ± 9.28	94.73 ± 8.42	98.53 ± 6.76	0.122
MAPn (mmHg)	88.06 ± 8.56	81.8 ± 7.75	79.58 ± 5.33	0.0005	0.0007*
					0.030**
NBPF (%)	6.49 ± 2.33	12.83 ± 1.64	19.19 ± 3.17

*Comparison between Groups 1 and 3; **comparison between Groups 1 and 2; ***comparison between Groups 2 and 3.

Mean SBP, 24-h mean systolic blood pressure; Mean DBP, 24-h mean diastolic blood pressure; SBP min, minimal systolic blood pressure; DBP min, minimal diastolic blood pressure; MAPd, diurnal mean arterial pressure; MAPn, nocturnal mean arterial pressure; NBPF, night blood pressure fall.

Table IV. The results of ophthalmological examination within the groups, depending on the level of mean arterial pressure at night (MAPn).

	Group A (MAPn<79)	Group B (MAPn 79–87)	Group C (MAPn>87)	Anova or Kruskal–Wallis test, p	Bonferroni or Dunn's correction, p
Number of patients	20	27	22
Age (years)	50.7 ± 15.53	55.22 ± 17.63	59.77 ± 13.37	0.184
IOPd (mmHg)	17.75 ± 2.24	16.33 ± 2.34	15.27 ± 2.39	0.006	0.005*
IOPn (mmHg)	18.1 ± 2.53	16.11 ± 2.45	15.23 ± 2.39	0.005	0.004*
					0.083**
OPPd (mmHg)	42.11 ± 3.78	46.23 ± 5.08	53.69 ± 5.01	<0.000001	<0.000001*
					0.011**
					0.000001***
OPPn (mmHg)	32.5 ± 3.49	38.65 ± 2.37	47.95 ± 4.47	<0.0001	<0.000001*
					<0.000001**
					<0.000001***
RNFL (μm)	111.37 ± 29.08	118.45 ± 26.14	126.15 ± 25.31	0.246
VFD (%)	40 ± 19.12	33.52 ± 17.36	28.40 ± 16.72	0.113
VEP A (μV)	7.1085 ± 5.18	8.47 ± 4.64	9.35 ± 4.46	0.088
VEP L (m/s)	128.51 ± 11.66	122 ± 12.08	118.77 ± 10.45	0.025	0.023*

*Comparison between Groups A and B; **comparison between Groups A and B; ***comparison between Groups B and C. IOPd, mean intraocular pressure during the day; IOPn, mean intraocular pressure at night; OPPd, ocular perfusion pressure during the day; OPPn, ocular perfusion pressure at night; RNFL, retinal nerve fiber layer thickness; VFD, visual field defect; VEP A, visual evoked potentials – amplitude; VEP L, visual evoked potentials – latency.

Table V. Parameters of the flow in the retrobulbar vessels in the three groups, depending on the value of mean arterial pressure at night (MAPn).

	Group A (MAPn<79)	Group B (MAPn 79–87)	Group C (MAPn>87)	Anova or Kruskal–Wallis test, p	Bonferroni or Dunn's correction, p
OA-PSV (cm/s)	25.75 ± 10.51	24.75 ± 9.94	34.69 ± 8.52	0.002	0.028*
					0.002***
OA-EDV (cm/s)	7.03 ± 4.94	7.86 ± 5.35	10.64 ± 3.99	0.039	0.047*
OA-RI	0.77 ± 0.19	0.76 ± 0.18	0.73 ± 0.16	0.38
CRA-PSV (cm/s)	11.05 ± 3.85	11.11 ± 3.71	14.35 ± 3.52	0.005	0.016*
					0.011***
CRA-EDV (cm/s)	3.91 ± 1.48	4.36 ± 1.95	5.98 ± 1.52	0.002	0.002*
					0.020***
CRA-RI	0.67 ± 0.14	0.63 ± 0.13	0.62 ± 0.09	0.258
SPCA-PSV (cm/s)	9.67 ± 2.25	10.64 ± 1.91	11.57 ± 1.70	0.007	0.006*
SPCA-EDV (cm/s)	4.39 ± 1.85	5.09 ± 1.81	5.26 ± 0.95	0.274
SPCA-RI	0.54 ± 0.19	0.53 ± 0.17	0.57 ± 0.10	0.432

*Comparison between Groups A and C; **comparison between Groups A and B; ***comparison between Groups B and C.

OA-PSV, ophthalmic artery peak systolic velocity; OA-EDV, ophthalmic artery end-diastolic velocity; OA-RI, ophthalmic artery vascular resistance index; CRA-PSV, central retinal artery peak systolic velocity; CRA-EDV, central retinal artery end-diastolic velocity; CRA-RI, central retinal artery resistance index.

Table VI. The Spearman rang order correlations between the parameters of the retrobulbar flow vessels and the values of arterial blood pressure in ambulatory blood pressure monitoring (ABPM) for the whole group.

	SBP min (mmHg)	DBP min (mmHg)	MAPd (mmHg)	MAPn (mmHg)	NBPF (%)
OA-PSV (cm/s)	0.25	0.58	−0.03	0.28	−0.58
	p = 0.039	p < 0.000001	p = 0.825	p = 0.021	p < 0.00001
OA-EDV (cm/s)	0.18	0.64	−0.19	0.25	0.66
	p = 0.138	p < 0.000001	p = 0.121	p = 0.038	p < 0.000001
OA-RI	−0.18	−0.57	0.31	−0.13	0.66
	p = 0.147	p < 0.000001	p = 0.008	p = 0.275	p < 0.000001
CRA-PSV (cm/s)	0.31	0.48	−0.05	0.26	−0.55
	p = 0.009	p < 0.00003	p = 0.710	p =0.031	p < 0.000001
CRA-EDV (cm/s)	0.31	0.57	−0.06	0.39	−0.72
	p = 0.010	p < 0.000001	p = 0.633	p < 0.0008	p < 0.000001
CRA-RI	−0.169	−0.48	0.16	−0.19	0.54
	p = 0.166	p < 0.00003	p = 0.191	p =0.107	p < 0.00002
SPCA-PSV (cm/s)	0.22	0.23	0.26	0.40	−0.28
	p = 0.074	p = 0.052	p = 0.030	p < 0.0007	p = 0.021
SPCA-EDV (cm/s)	0.14	0.07	0.01	0.20	0.26
	p = 0.261	p = 0.566	p = 0.941	p = 0.095	p = 0.030
SPCA-RI	−0.12	0.14	0.11	0.04	−0.01
	p = 0.353	p = 0.242	p = 0.350	p = 0.717	p = 0.954
RNFL (μm)	0.08	0.30	−0.14	−0.13	0.33
	p = 0.504	p = 0.011	p = 0.726	p = 0.292	p = 0.005
VFD (%)	0.33	−0.48	0.19	−0.22	0.62
	p = 0.005	p = 0.00004	p =0.112	p = 0.069	p < 0.0000001
OPPd (mmHg)	0.26	0.27	0.92	0.73	0.13
	p =0.031	p =0.023	p < 0.000001	p < 0.000001	p = 0.300
OPPn (mmHg)	0.48	0.57	0.62	0.91	−0.40
	p = 0.00004	p < 0.000001	p < 0.000001	p < 0.000001	p = 0.0006
IOPd (mmHg)	−0.31	−0.44	−0.12	−0.32	0.28
	p = 0.10	p = 0.0001	p = 0.338	p = 0.008	p = 0.018
IOPn (mmHg)	−0.34	−0.43	−0.20	−0.36	0.21
	p = 0.004	p = 0.0002	p = 0.094	p = 0.002	p = 0.083

OA-PSV, ophthalmic artery peak systolic velocity; OA-EDV, ophthalmic artery end-diastolic velocity; OA-RI, ophthalmic artery vascular resistance index; CRA-PSV, central retinal artery peak systolic velocity; CRA-EDV, central retinal artery end-diastolic velocity; CRA-RI, central retinal artery resistance index; SPCA-PSV, short posterior ciliary arteries peak systolic velocity; SPCA-EDV, short posterior ciliary arteries end-diastolic velocity; SPCA-RI, short posterior ciliary arteries resistance index; IOPd, mean intraocular pressure during the day; IOPn, mean intraocular pressure at night; OPPd, ocular perfusion pressure during the day; OPPn, ocular perfusion pressure at night; RNFL, retinal nerve fiber layer thickness; VFD, visual field defect.

Table VII. The Spearman rang order correlations between the parameters of the flow in the retrobulbar vessels and the ocular perfusion pressure (OPP), retinal nerve fiber layer thickness (RNFL) and visual field defect (VFD) values.

	OPPd (mmHg)	OPPn (mmHg)	RNFL (μm)	VFD (%)
OA-PSV (cm/s)	0.07	0.3	0.40	0.63
	p = 0.545	p = 0.010	p = 0.006	p < 0.000001
OA-EDV (cm/s)	−0.05	0.33	0.26	0.59
	p = 0.698	p = 0.006	p = 0.028	p < 0.000001
OA-RI	0.16	−0.22	−0.22	0.54
	p = 0.195	p = 0.07	p = 0.066	p = 0.000002
CRA-PSV (cm/s)	0.09	0.30	0.39	−0.52
	p = 0.473	p = 0.012	p = 0.001	p = 0.000004
CRA-EDV (cm/s)	0.05	0.40	0.34	−0.57
	p = 0.679	p = 0.0007	p = 0.004	p < 0.000001
CRA-RI	0.04	−0.23	−0.15	0.39
	p = 0.767	p = 0.052	p = 0.207	p = 0.0009

OA-PSV, ophthalmic artery peak systolic velocity; OA-EDV, ophthalmic artery end-diastolic velocity; OA-RI, ophthalmic artery vascular resistance index; CRA-PSV, central retinal artery peak systolic velocity; CRA-EDV, central retinal artery end-diastolic velocity; CRA-RI, central retinal artery resistance index; SPCA-PSV, short posterior ciliary arteries peak systolic velocity; SPCA-EDV, short posterior ciliary arteries end-diastolic velocity; SPCA-RI, short posterior ciliary arteries resistance index; IOPd, mean intraocular pressure during the day; IOPn, mean intraocular pressure at night; OPPd, ocular perfusion pressure during the day; OPPn, ocular perfusion pressure at night.

Figure 1. The correlation between the nocturnal blood pressure fall (NBPF) and the visual field defect in the whole group of patients.