A clinical investigation to evaluate the association of glaucoma with systemic hypertension and its effect on visual morbidity: a prospective study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 4017-4023
AbstractAim: the aim of the present study to evaluate the clinical correlation of glaucoma with systemic hypertension and its effect on visual morbidity.
Methods: This was a prospective study conducted in the Department of Ophthalmology, AIIMS, Patna, Bihar, India, for 15 months. It was performed on 100 patients between the age groups of 30 to 65 years which included newly diagnosed hypertensives and previously diagnosed hypertensive receiving treatment and on follow up now. Patients are classified as hypertensive based on elevated BP readings of >120/80 mm Hg on two separate occasions according to current American Heart Association. The oral hypotensive medication taken by patients were categorized into 5 groups as calcium channel blockers(CCB), diuretics, angiotensin converting enzyme inhibitors (ACE), angiotensin receptor blockers and beta blockers. Glaucoma was defined as progressive optic neuropathy associated with visual field loss in which IOP is a modifiable factor according ICO Glaucoma Guidelines.
Results: Among the 100 hypertension patients involved in the study, 56 patients (56%) were found to have glaucoma. 59 patients (59%) were female and 41 patients (41%) were male. Age group affected was 14% between 30-40 years, 25% between 50 to 60 years and 61% between 60 and 70 years, the mean age being 58.7 years. The increased incidence of OHT among hypertensives was statistically significant with a p value of 0.01. Decreased IOP was highest among patients taking CCB in 24 patients (50%), followed by beta blockers in 2 patients (28.57%), ACE inhibitors11 patients (37.93%), ARB 5 patients (41.67%)and diuretics in 1 patient (25%). The range of IOP in the treated population was between 10-16mmHg and this difference in those on hypertension medications was statistically significant with p value = 0. 02.
Conclusion: Hypertension can cause both reduction and elevation in IOP. Treatment of hypertension does lower the IOP and prevent further progression of glaucoma and prevent any visual loss.
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