A comparative study on association between systemic hypertension, perfusion pressure and glaucoma in an adult population of north karnataka

Abstract

Purpose: Glaucoma, a leading cause of blindness, involves progressive retinal ganglion cell loss and optic nerve damage. It affects 3.54% of individuals aged 40-80, with a higher prevalence in Africa and Asia. Raised intraocular pressure is a known risk factor, but blood supply to the optic nerve also plays a role. Systemic hypertension and nocturnal blood pressure drops may influence glaucoma, though their exact relationship remains unclear. This study aims to examine the impact of blood pressure and perfusion pressures on glaucoma in North Karnataka’s adult population. Materials and Methods: This cross-sectional study on the association between systemic hypertension, perfusion pressure, and glaucoma was conducted in hypertensives and normotensives from May 2023 to December 2024. A comprehensive eye examination was conducted, including blood pressure and intraocular pressure measurements, from which mean perfusion pressures were calculated. Statistical analysis was performed using the Chi-square test, Mann Whitney U test, Spearman rho and Kruskal Wallis Test at p<0.05 significance. Results: This study evaluated 168 participants (84 hypertensive cases and 84 normotensive controls). Hypertensive individuals showed significantly higher intraocular and ocular perfusion pressure than controls at all time intervals (p<0.05). Blood pressure was highest at 1 pm and 6 pm. OPP values were positively correlated with systolic, diastolic, and mean arterial pressures (P<0.05). Antihypertensive medications significantly influenced OPP, with patients on combined medications showing the highest OPP. Conclusion: This study underscores the importance of screening hypertensive individuals for glaucoma, emphasizing the need to carefully evaluate blood pressure, intraocular pressure and ocular perfusion pressures. Managing these factors is crucial for preventing optic nerve damage and glaucoma progression.