J Korean Ophthalmol Soc.  2013 Sep;54(9):1371-1378.

Diurnal Blood Pressure Variation in the Retinal Vein Occlusion

• Park SJ
• Moon SW
• Lim SH
• Yoon IH
• Choi KN
• Lee HY

Abstract

PURPOSE
The purpose of this study was to determine the diurnal blood pressure variation with retinal vein occlusion (RVO) using 24-hour ambulatory blood pressure monitoring (24-hour ABPM).
METHODS
The subjects in this study visited the department of ophthalmology from May 2012 to December 2012 and were diagnosed with RVO but had no history of hypertension (HTN). Non-dipper was defined as a nocturnal systolic blood pressure (SBP) decrease less than 10%. These values were used to compare the 24-hour ABPM values of the RVO and the control groups.
RESULTS
The 24-hour ABPM values, with the exception of the mean nightly SBP, were statistically different whne the RVO group was compared with the control group. The odds of an RVO patient being a non-dipper compared to dipper were 1.81 times greater than in the control. Additionally, the clinical SBP and DBP in the RVO group were not significantly different when the HTN group and the non-HTN group were compared. In contrast, the mean 24-hour SBP and the mean DBP were significantly different in regard to HTN.
CONCLUSIONS
Patients with RVO have a tendency to maintain high BP throughout the day and also during the night. A patient with non-dipper status can be at risk for RVO, even if the patient does not have HTN. Therefore, 24-hour ABPM is an effective management approach for HTN in addition to strict BP control in patients with RVO.

Keyword

Non-dipper; Retinal vein occlusion; Target organ damage; 24-hour ambulatory blood pressure monitoring

MeSH Terms

Blood Pressure
Blood Pressure Monitoring, Ambulatory
Humans
Hypertension
Ophthalmology
Retinal Vein
Retinal Vein Occlusion
Retinaldehyde
Retinaldehyde

Reference

References

1. Cugati S, Wang JJ, Rochtchina E, Mitchell P. Ten-year incidence of retinal vein occlusion in an older population: the Blue Mountains Eye Study. Arch Ophthalmol. 2006; 124:726–32.

2. Lattanzio R, Torres Gimeno A, Battaglia Parodi M, Bandello F. Retinal vein occlusion: current treatment. Ophthalmologica. 2011; 225:135–43.

3. Mitchell P, Smith W, Chang A. Prevalence and associations of reti-nal vein occlusion in Australia. The Blue Mountains Eye Study. Arch Ophthalmol. 1996; 114:1243–7.

4. Klein R, Klein BE, Moss SE, Meuer SM. The epidemiology of reti-nal vein occlusion: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 2000; 98:133–43.

5. Rogers S, McIntosh RL, Cheung N. . The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010; 117:313–9.e1.

6. Wong TY, Scott IU. Clinical practice Retinal-vein occlusion. N Engl J Med. 2010; 363:2135–44.

7. Laouri M, Chen E, Looman M, Gallagher M. The burden of disease of retinal vein occlusion: review of the literature. Eye (Lond). 2011; 25:981–8.

8. Dithmar S, Hansen LL, Holz FG. [Retinal vein occlusions]. Ophthalmologe. 2003; 100:561–77.

9. Feist RM, Ticho BH, Shapiro MJ, Farber M. Branch retinal vein occlusion and quadratic variation in arteriovenous crossings. Am J Ophthalmol. 1992; 113:664–8.

10. Green WR, Chan CC, Hutchins GM, Terry JM. Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. Retina. 1981; 1:27–55.

11. Frangieh GT, Green WR, Barraquer-Somers E, Finkelstein D. Histopathologic study of nine branch retinal vein occlusions. Arch Ophthalmol. 1982; 100:1132–40.

12. Weinberg D, Dodwell DG, Fern SA. Anatomy of arteriovenous crossings in branch retinal vein occlusion. Am J Ophthalmol. 1990; 109:298–302.

13. Wong TY, Larsen EK, Klein R. . Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: the Atherosclerosis Risk in Communities & Cardiovascular Health studies. Ophthalmology. 2005; 112:540–7.

14. Cheung N, Klein R, Wang JJ. . Traditional and novel car-diovascular risk factors for retinal vein occlusion: the multiethnic study of atherosclerosis. Invest Ophthalmol Vis Sci. 2008; 49:4297–302.

15. Chua B, Kifley A, Wong TY, Mitchell P. Homocysteine and retinal vein occlusion: a population-based study. Am J Ophthalmol. 2005; 139:181–2.

16. White WB, Morganroth J. Usefulness of ambulatory monitoring of blood pressure in assessing antihypertensive therapy. Am J Cardiol. 1989; 63:94–8.

17. Floras JS, Hassan MO, Jones JV. . Factors influencing blood pressure and heart rate variability in hypertensive humans. Hypertension. 1988; 11:273–81.

18. Pickering TG, James GD, Boddie C. . How common is white coat hypertension? JAMA. 1988; 259:225–8.

19. Chobanian AV, Bakris GL, Black HR. . Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003; 42:1206–52.

20. London NJ, Brown G. Update and review of central retinal vein occlusion. Curr Opin Ophthalmol. 2011; 22:159–65.

21. Madhusudhana KC, Newsom RS. Central retinal vein occlusion: the therapeutic options. Can J Ophthalmol. 2007; 42:193–5.

22. Zhao J, Sastry SM, Sperduto RD. . Arteriovenous crossing pat-terns in branch retinal vein occlusion. The Eye Disease Case- Control Study Group. Ophthalmology. 1993; 100:423–8.

23. Duker JS, Brown GC. Anterior location of the crossing artery in branch retinal vein obstruction. Arch Ophthalmol. 1989; 107:998–1000.

24. Seitz R. The retinal vessels: comparative ophthalmoscopic and his-tologic studies on healthy and diseased eyes. 1964. St. Louis: CV Mosby.

25. Kumar B, Yu DY, Morgan WH. . The distribution of angioarch-itectural changes within the vicinity of the arteriovenous crossing in branch retinal vein occlusion. Ophthalmology. 1998; 105:424–7.

26. Clemett RS. Retinal branch vein occlusion. Changes at the site of obstruction. Br J Ophthalmol. 1974; 58:548–54.

27. Kumar V, Abbas AK, Fausto N. . Robbins and Cotran patho-logic basis of disease. 7th ed. Vinay Kumar, Abul K Abbas, Nelson Fausto, eds. 2005. Philadelphia; London: Elsevier Saunders.

28. Dennis Kasper, Eugene Braunwald, Anthony Fauci. . Harrison's manual of medicine. 2005. 16th ed. New York; London: McGraw-Hill.

29. Frohlich ED, Tarazi RC. Is arterial pressure the sole factor respon-sible for hypertensive cardiac hypertrophy? Am J Cardiol. 1979; 44:959–63.

30. White WB. Diurnal blood pressure and blood pressure variability in diabetic normotensive and hypertensive subjects. J Hypertens Suppl. 1992; 10:S35–41.

31. Liniger C, Favre L, Assal JP. Twenty-four hour blood pressure and heart rate profiles of diabetic patients with abnormal car-diovascular reflexes. Diabet Med. 1991; 8:420–7.

32. Munakata M, Imai Y, Abe K. . Involvement of the hypothal-amo-pituitary-adrenal axis in the control of circadian blood pres-sure rhythm. J Hypertens Suppl. 1988; 6:S44–6.

33. Kersh ES, Kronfield SJ, Unger A. . Autonomic insufficiency in uremia as a cause of hemodialysis-induced hypotension. N Engl J Med. 1974; 290:650–3.

34. Imai Y, Abe K, Munakata M. . Circadian blood pressure variations under different pathophysiological conditions. J Hypertens Suppl. 1990; 8:S125–32.

35. Yamamoto Y, Akiguchi I, Oiwa K. . Adverse effect of night-time blood pressure on the outcome of lacunar infarct patients. Stroke. 1998; 29:570–6.

36. Ferrara AL, Pasanisi F, Crivaro M. . Cardiovascular abnormal-ities in never-treated hypertensives according to nondipper status. Am J Hypertens. 1998; 11((11 Pt 1)):1352–7.

37. Shimada K, Kawamoto A, Matsubayashi K, Ozawa T. Silent cere-brovascular disease in the elderly. Correlation with ambulatory pressure. Hypertension. 1990; 16:692–9.

38. Verdecchia P, Schillaci G, Guerrieri M. . Circadian blood pres-sure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990; 81:528–36.

39. Bianchi S, Bigazzi R, Baldari G. . Diurnal variations of blood pressure and microalbuminuria in essential hypertension. Am J Hypertens. 1994; 7:23–9.

40. Verdecchia P, Porcellati C, Schillaci G. . Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension. 1994; 24:793–801.