Ambulatory blood pressure in patients with glaucoma.

Purpose: Any clinical condition causing hypoperfusion at the level of optic nerve head represents a risk factor for the developing of glaucoma damage. In most normal subjects is observed that diurnal blood pressure curve presents night"dip" (about 12% of day-time values). Methods: We assessed the influence of the circadian blood pressure (BP) profile on the presence of visual field defects (VFD) in patients with glaucoma. We performed masked assessment of visual field and 24-hour noninvasive ambulatory BP monitiring (spacelabs 90207 recorder) in 3 groups of patients: 1) twenty patients with myopia and open angle glaucoma (MOAG); 2) twenty patients with primary openangle glaucoma (POAG); 3) nine patients with normal tension glaucoma. A fourth group of fifteen ealthy normotensive volunteers had its BP monitored as reference controls. Results: Our samples of MOAG, POAG and NTG had lower ambulatory day and night BP values than normotensive controls, even if the differences were not statistically significant. Considering all the groups we observed that patients with progressive VFD have night sistolic "dip" higher than patients with stable VFD (Kruskas Wallis test: p.= 0.01). This feeding could influence the progression of the glaucomatouse disease in these patients, as it can be inferred from a correlation between low systolic night BP values and VFD (R.=0.4). Conclusion: Arterial blood pressure values lower than healthy normotensive subjects can be considered as risk factor in the progression of VFD in glaucomatous patients. An exagerated must be considered in patients presenting evolutive glaucoma damage.