Journal article
Beta-blocker eyedrops and nocturnal arterial hypotension
American journal of ophthalmology, Vol.128(3), pp.301-309
1999
DOI: 10.1016/S0002-9394(99)00160-9
PMID: 10511024
Abstract
PURPOSE:
To investigate the effects of topical beta-blocker eyedrops on nocturnal arterial hypotension and heart rate and on visual field deterioration.
METHODS:
We prospectively investigated 275 white patients, 161 with glaucomatous optic neuropathy and 114 with nonarteritic anterior ischemic optic neuropathy, by 24-hour ambulatory blood pressure monitoring and diurnal curve of intraocular pressure, in addition to detailed ophthalmic evaluation. Of the patients with glaucomatous optic neuropathy, 131 had normal-tension glaucoma and 30 had primary open-angle glaucoma. Of the 275 patients, 114 were using topical beta-blocker eyedrops twice daily (76 with normal-tension glaucoma, 26 with primary open-angle glaucoma, and 12 with anterior ischemic optic neuropathy).
RESULTS:
Hourly average blood pressure data analyses showed overall a drop in blood pressure as well as heart rate during sleep, and a significantly greater drop in mean diastolic blood pressure (
P = .009) at night in normal-tension glaucoma than in anterior ischemic optic neuropathy. Also, patients using beta-blocker eyedrops experienced a significantly greater percentage drop in diastolic blood pressure at night (
P = .028), lower minimum nighttime diastolic blood pressure (
P = .072), and lower minimum nighttime heart rate (
P = .002) than did those not using them. In normal-tension glaucoma, eyes receiving beta-blocker eyedrops showed visual field progression significantly (
P = .0003) more often than those not receiving beta-blockers.
CONCLUSIONS:
The findings of our studies, as well as those of others, suggest that any factor that increases nocturnal arterial hypotension is a potential risk factor in vulnerable individuals with glaucomatous optic neuropathy or anterior ischemic optic neuropathy. The present study suggests that the use of beta-blocker eyedrops, by aggravating nocturnal arterial hypotension and reducing the heart rate, may be a potential risk factor in susceptible individuals.
Details
- Title: Subtitle
- Beta-blocker eyedrops and nocturnal arterial hypotension
- Creators
- Sohan Singh Hayreh - Department of Ophthalmology (Dr Hayreh and Ms Podhajsky), College of Medicine, University of Iowa, Iowa City, Iowa, USAPatricia Podhajsky - Department of Ophthalmology (Dr Hayreh and Ms Podhajsky), College of Medicine, University of Iowa, Iowa City, Iowa, USAM.Bridget Zimmerman - Preventive Medicine and Environmental Health (Division of Biostatistics) (Dr Zimmerman), College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- American journal of ophthalmology, Vol.128(3), pp.301-309
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0002-9394(99)00160-9
- PMID
- 10511024
- ISSN
- 0002-9394
- eISSN
- 1879-1891
- Language
- English
- Date published
- 1999
- Academic Unit
- Biostatistics; Ophthalmology and Visual Sciences
- Record Identifier
- 9983997466102771
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