Key result
Acute BP lowering in severe hypertension reduces intraocular pressure by ~1.5 mmHg.
Why the study?
Previous studies have shown an association between systemic hypertension and intraocular pressure, but the acute effect of systemic blood pressure reduction on intraocular pressure in hypertensive patients was not studied in an emergency setting.
Case-Control (n=214)
No
Mean Difference: 1.5 (95% CI 1.13–1.87)
Absolute Event Rate: 13.78% vs 15.29%
p-value: p=<0.001
BP control may lower IOP in hypertensives; hypothesis-generating and requires prospective trials before practice change.
OBJECTIVES: Previous studies have shown an association between systemic hypertension and intraocular pressure (IOP). We analyzed the relationship between the decreases of the blood pressure (BP) and IOP in hypertensive patients. METHODS: The study includes a total of 214 patients: 158 hypertensive and 56 normotensive patients as study and control groups, respectively. The IOP of each eye in both the groups was measured once with a noncontact tonometer at presentation and an hour after BP reduction to normal in the study group. We analyzed the reduction in IOP with decreasing BP. RESULTS: In the study group, the mean IOP was 15.29 ± 4.05 mmHg in the right and 15.11 ± 3.78 mmHg in the left eyes. The mean IOP measured an hour after the patients became normotensive was 13.78 ± 4.06 mmHg in the right and 13.51 ± 3.82 in the left eyes. There was a statistically significant decrease in the IOPs ( P < 0.001). The mean IOP in the control group was 13.54 ± 3.51 mmHg in the right and 13.20 ± 3.33 mmHg in the left eyes. The mean IOP at presentation in the study and control groups was found to be significantly different ( P < 0.001). CONCLUSIONS: Patients in the study group showed a significantly higher IOP compared to patients in the normotensive group. Furthermore, patients in the study group showed a significant reduction in IOP after BP reduction. This may indicate that uncontrolled hypertension poses a risk for prolonged higher IOP. Prolonged higher IOP can be considered a risk factor for the glaucoma.
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Tiambeng et al. (2022) conducted a case-control in Severe hypertension (hypertensive urgency/emergency) (n=214). Systemic blood pressure reduction (antihypertensive treatment) vs. Pre-treatment baseline was evaluated on Reduction in intraocular pressure of the right eye after blood pressure reduction to normal (MD 1.50, 95% CI 1.13-1.87, p=<0.001). Acute systemic blood pressure reduction with antihypertensive treatment significantly decreased right eye intraocular pressure by a mean of 1.50 mmHg in patients with severe hypertension.
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