EXPRESS: Relationship between nocturnal blood pressure variations and intraocular pressure in patients with essential hypertension

This study aimed to evaluate the association between intraocular pressure (IOP) and circadian blood pressure (BP) patterns-specifically dipper and nondipper status-in patients with newly diagnosed essential hypertension. A total of 180 participants were enrolled and equally divided into individuals with normal blood pressure (n=90) and individuals with hypertension (n=90). Individuals with hypertension were further classified into dipper and nondipper subgroups based on 24-hour ambulatory BP monitoring. IOP was assessed using a noncontact tonometer during morning hours (9:00 a.m.-12:00 p.m.). Individuals with hypertension demonstrated significantly higher right and left eye IOP values compared to individuals with normal blood pressure (16.86 ± 3.84 mmHg vs. 14.56 ± 2.79 mmHg and 16.69 ± 4.02 mmHg vs. 14.43 ± 3.08 mmHg, respectively; both p<0.001). Among hypertensives, nondippers had significantly higher IOP than dippers (right eye: 17.91 ± 3.93 vs. 15.85±3.52 mmHg, p=0.010; left eye: 17.88±3.98 vs. 15.55±3.76 mmHg, p=0.005). Linear regression analysis identified 24-hour systolic BP (β=0.902, 95% CI: 0.220-0.395, p<0.001) and nondipper status (β=-0.608, 95% CI: -7.294 to -3.218, p<0.001) as independent predictors of mean IOP in individuals with newly diagnosed and untreated hypertension. ROC analysis revealed that, in individuals with newly diagnosed and untreated hypertension, a mean IOP ≥16.85 mmHg predicted nondipping status with 59.1% sensitivity and 63% specificity (AUC=0.666, p=0.007). These findings suggest that a nondipping circadian BP profile is independently associated with elevated IOP in individuals with newly diagnosed and untreated hypertension, emphasizing the potential value of ocular pressure monitoring in this population, particularly those without nocturnal BP decline.