Increased blood pressure found in patients with BRVO
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Patients with branch retinal vein occlusion saw significant differences in systolic, diastolic and arterial blood pressure compared with control patients over a 24-hour period, according to findings published in Retina.
Mehmet Gulmez, MD, of The Dunya Goz Eye Hospital, and Abdulhakim Tekce, MD, of The Maya Eye Hospital, both in Turkey, sought to evaluate short-term blood pressure variability over 24 hours in patients with branch retinal vein occlusion (BRVO) vs. control patients.
“Hemodynamic changes in the retinal vessels, perhaps associated with changes in posture, might also play an important role in the development of RVO and its eventual occurrence,” Gulmez and Tekce wrote.
The researchers analyzed data from a prospective, cross-sectional, comparative, case-control study of 80 patients and 75 control patients. In a 24-hour period, each participant had their blood pressure measured by ambulatory monitoring every 15 minutes during the day and every 30 minutes at night.
Gulmez and Tekce wrote that the mean variables of systolic BP, diastolic BP, arterial BP and a variability index recorded during the day, at night and throughout the 24-hour period were subjected to statistical analyses.
The researchers identified that mean daytime, nighttime and 24-hour systolic, diastolic and arterial BP did not significantly differ between the groups. But mean variability index values of daytime, nighttime and 24-hour systolic, diastolic and arterial BP significantly increased in patients with BRVO vs. controls.
“When evaluated with the results of other studies, our findings also suggest that BPV [blood pressure variability] factors into the pathogenesis of BRVO and might even cause its rapid progression,” Gulmez and Tekce wrote. “However, additional prospective studies with larger samples and longer follow-up periods remain necessary to clarify the association of BPV and BRVO.”
Perspective
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Steven Ferrucci, OD, FAAO
This study shows that increasing variability in short term BP over 24 hours is associated with BRVO, the second most common vascular disease affecting the retina. As clinicians, if we are referring a patient with a BRVO to primary care for evaluation of their systemic risk factors, BPV should be included. Further, since this is a relatively new concept, most PCPs would most likely be unaware of this association. Thus, a quick note asking to have systemic risk factors in BRVO patients, such as diabetes, hypertension as well as this new concept, BPV, should be suggested. Also, PCPs should be educated that BRVOs should be considered in their patients with high BPV and visual changes.
Some limitations of the study include that patients were taking hypertensive medications, and their effect on BPV is unknown. Also, while BPV was shown to be a risk factor, the researchers did not evaluate how this variation may affect prognosis. Lastly, the study looked at only short-term BPV, not long term, so the effect of long-term variation is unclear.
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