24-hour Ambulatory Blood Pressure in Normal Tension Glaucoma: Associations with Retinal Vessel Diameter and Visual Field Defect Progression

PURPOSE: To investigate the correlation between 24-hour ambulatory blood pressure (BP) monitoring and peripapillary retinal vessel width and visual field (VF) defect progression in normal tension glaucoma (NTG) patients. METHODS: All patients were classified by 24-hour ambulatory BP monitoring as non-dipper (nocturnal dip < 10%) and dipper (nocturnal dip ≥ 10%) group. Vessel diameter, mean deviation (MD) value by VF test and VF progression from Glaucoma Progression Analysis (GPA) were compared among non-dipper and dipper groups. RESULTS: Retinal arterial diameter was wider in the non-dipper group compared to the dipper group (p = 0.015), while retinal venous diameter had no significant relationship between the two groups (p = 0.131). The MD value at baseline and 2 years after was worse in the non-dipper group than the dipper group, respectively (p = 0.006, p = 0.030). But, there was no significant relationship between nocturnal dip and GPA progression (p = 0.658). CONCLUSIONS: There was a statistically significant correlation between nocturnal dips and retinal arterial diameter and MD values. These results suggest that non-invasive fundus photography can predict hemodynamic features like nocturnal dip.

Long-term smoking patients with essential hypertension complicated with 24 hours ambulatory blood pressure monitoring and analysis / 中国医师进修杂志

Objective To observe the long-term smokers with primary hypertension patients characteristics and changes in the circadian rhythm of blood by non-invasive 24-hour ambulatory blood pressure monitoring (ABPM),so as to long-term smokers with primary hypertension the prevention and treatment of patients provide a theoretical reference.Methods A total of 200 cases with essential hypertension from February to October 2012 were divided into 2 groups,group A of 100 patients with longterm smoking (smoked ＞ 10 years the daily smoking 30-40 sticks) with primary hypertension crowd;group B of primary hypertension in 100 patients with non-smoking.All patients underwent 24-hour ABPM the patient's consent,were disabled antihypertensive drugs 1 week,its non-invasive 24-hour ABPM,two groups were compared for 24 h average systolic blood pressure (24 h SBP),24-hour average diastolic pressure (24 h DBP),diurnal mean systolic blood pressure (dSBP),mean nighttime systolic blood pressure (nSBP),daytime average diastolic blood pressure (dDBP),night mean diastolic blood pressure (nDBP)and nighttime systolic blood pressure decreased percentage.Results 24 h SBP,24 h DBP,dSBP,nSBP,dDBP,nDBP in group A were higher than those in group B [(139.60 ± 11.69) mmHg (1 mmHg =0.133kPa) vs.(133.90 ± 12.73) mmHg,(82.03 ± 7.44) mmHg vs.(72.58 ± 8.97) mmHg,(152.50 ± 9.79)mmHg vs.(141.30 ±8.92) mmHg,(84.97 ±7.65) mmHg vs.(76.24 ±8.06) mmHg,(138.20 ±8.73)mmHg vs.(127.00 ±9.74) mmHg,(78.52 ± 10.49) mmHg vs.(68.45 ± 11.01) mmHg,and there were statistically significant differences (P ＜ 0.05); hypertension percentage at night systolic blood pressure in group B was lower than that in group A [(6.23 ± 1.79)％ vs.(10.14 ±2.46)％],there was significant difference (P ＜ 0.05).Conclusions Long-term smoking can make the average blood pressure of essential hypertension crowd 24 h,daytime blood pressure and elevated blood pressure at night,and the long-term smoking population in essential hypertension circadian adjustment feature to affect larger,so as soon as possible to promote smoking cessation and long-acting antihypertensive drugs,thereby reducing the incidence of heart,brain,kidney and other target organ damage.

Diurnal Blood Pressure Variation in the Retinal Vein Occlusion

PURPOSE: The purpose of this study was to determine the diurnal blood pressure variation with retinal vein occlusion (RVO) using 24-hour ambulatory blood pressure monitoring (24-hour ABPM). METHODS: The subjects in this study visited the department of ophthalmology from May 2012 to December 2012 and were diagnosed with RVO but had no history of hypertension (HTN). Non-dipper was defined as a nocturnal systolic blood pressure (SBP) decrease less than 10%. These values were used to compare the 24-hour ABPM values of the RVO and the control groups. RESULTS: The 24-hour ABPM values, with the exception of the mean nightly SBP, were statistically different whne the RVO group was compared with the control group. The odds of an RVO patient being a non-dipper compared to dipper were 1.81 times greater than in the control. Additionally, the clinical SBP and DBP in the RVO group were not significantly different when the HTN group and the non-HTN group were compared. In contrast, the mean 24-hour SBP and the mean DBP were significantly different in regard to HTN. CONCLUSIONS: Patients with RVO have a tendency to maintain high BP throughout the day and also during the night. A patient with non-dipper status can be at risk for RVO, even if the patient does not have HTN. Therefore, 24-hour ABPM is an effective management approach for HTN in addition to strict BP control in patients with RVO.

Difference in 24-Hour Ambulatory Blood Pressure in Normal Tension Glaucoma and Primary Open-Angle Glaucoma

PURPOSE: To evaluate the variation of 24-hours blood pressure in patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). METHODS: Thirty patients with NTG, 30 patients with POAG, and 30 normal controls were enrolled in this study. Each subjects underwent 24-hours ambulatory blood pressure monitoring. The variation of each parameter and difference among NTG, POAG, and control groups were compared. RESULTS: The lowest diastolic blood pressure (DBP) and the lowest mean arterial blood pressure (MAP) were significantly lower in the NTG group(51.9+/-11.3 mmHg and 66.9+/-13.1 mmHg) than in the POAG group(60.0+/-11.4 mmHg and 77.8+/-16.8 mmHg, p=0.048 and 0.024) and the control group(60.1+/-10.5 mmHg and 77.4+/-13.3 mmHg, p=0.047 and 0.031) during nighttime. More patients showed a lowest MAP less than 60 mmHg in the NTG group(8 patients, 27%) than in the POAG group(2 patients, 7%) and the control group(2 subjects, 7%, p=0.038 each). In addition, a decrease of more than 15% in DBP was more frequent in NTG group(17 patients, 57%) than in the POAG group(9 patients, 30%) and the control group(9 subjects, 30%, p=0.037 each). CONCLUSIONS: Nocturnal reduction in blood pressure may play an important role in the pathogenesis of NTG in some patients. Therefore, nighttime blood pressure should be considered as an important reference factor in diagnosis and treatment of NTG.

The Cprrelation between LVH, LV Function and 24-hour Ambulatory Blood Pressure Monitoring in Patients with Newly Diagnosed Hypertension

BACKGROUND: Left ventricular hypertrophy is one of the major cardiovascular risk factors. So it is generally thought to be a predictor of complication and prognosis of hypertension. The 24-hour noninvasive ambulatory blood pressure monitoring (ABP) has been shown to be superior to office BP inpredicting target organ involvement in patients with hypertension and assessing antihypertensivve therapy. To determine the correlation between blood pressure and left ventricular hypertrophy in patients with newly diaggnosed systemic hypertension, we evaluate blood pressure by 24-hour ABP, office BP and echocardiiographic parameters of left ventricular hypertrophy. METHODS: From january 1995 to September 1995, in 22 patients with untreated essential hypertension who were diagnosed recently (within 1 month). They were studied by 24-hour noninvasive ambulatory blood pressure monitoring and cross sectional, M-mode and pulsed Doppler echocardiography for examining the relation between ABP and echocardiographic parameters. In the present study, we divided the oatuebts by two groups; white-coat hypertensive group and sustained hypertensive group. RESULTS: 1) Among the 22 patients who were diagnosed by office blood pressure, the white-coat hypertension was in 7 cases (31.8%) and sustained hypertension was 15 cases (68.2%). 2) In sustained hypertensive group, LV mass, LV mass index and relative posterior septal wall thickness were significantly increased compared with white-cost hypertensive group. 3) 24-hour ABP and systolic BP and loading % were significantly correlated with relative posterior septal wall thickness (p<0.05). CONCLUSION: In patients with newly diagnosed hypertension (especially with sustained hypertension), there was left ventricular hypertrophy expressed by increasing of LV mass, LV mass index, and relative posterior septal wall thickness. And, there were close correlation between 24-hour ABP monitoring-especially systolic BP and loading % of systolic BP and LVH.