Document Type

Article

Blood Pressure Lowering and Glaucoma: One Size Does Not Fit All

Authors

Craig J. Brown
Merrill F. Elias, University of MaineFollow

Publication Title

American Journal of Hypertension

Publisher

Oxford Academic

Rights and Access Note

Copyright © 2025, © The Author(s) 2025. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

Publication Date

2025

First Page

422

Last Page

423

Issue Number

7

Volume Number

38

Abstract/ Summary

Extract

INTRODUCTION

Glaucoma is a leading cause of vision loss and blindness. It is a steadily progressive ischemic optic neuropathy with neuronal atrophy. Many older glaucoma patients experience progressive side vision loss despite optimum control of intraocular pressure. Nerve atrophy and vision loss are irreversible.1

Hypertension is recognized as a risk factor for glaucoma. After 30 years of studies, the pernicious effect of low blood pressure (BP) is recognized, but lacks consensus for optimal lower limits. In this paper, we focus on the adverse effects of low BP and nocturnal dipping on glaucoma. We make provisional recommendations for treating glaucoma patients with arterial hypertension.1

The Systolic Blood Pressure Intervention Trial (SPRINT) has been accepted as the basis for defining hypertension and “optimal” (aggressive) BP management. (See Table 1).2,3 Regrettably, none of the landmark hypertension trials, including SPRINT, considered measures of visual outcomes as part of the trial.1,2

...

A recent paper by Donker et al. highlights the importance of 24-hour ambulatory BP measurements (24ABPM) for understanding glaucoma, low BP, and vision loss. They studied the contribution of low BP to rates of vision loss. Patients had both office-based BP measurements and 24ABPM. Lower baseline systolic blood pressure (SBP) and 24-hour mean arterial pressure were most clearly associated with faster vision loss.4

Repository Citation

Craig J Brown, Merrill F Elias, Blood Pressure Lowering and Glaucoma: One Size Does Not Fit All, American Journal of Hypertension, Volume 38, Issue 7, July 2025, Pages 422–423, https://doi.org/10.1093/ajh/hpaf046

DOI

https://doi.org/10.1093/ajh/hpaf046

Version

post-print (i.e. final draft post-refereeing with all author corrections and edits)