BLOOD PRESSURE VARIABILITY IN PATIENTS WITH BRANCH RETINAL VEIN OCCLUSION

Deep vein thrombosis and its risk factors in neurodegenerative diseases: A markedly higher incidence in Parkinson's disease

BACKGROUND

Information on the incidence and risk factors of deep vein thrombosis (DVT) in neurodegenerative diseases is limited. We aimed to determine the incidence of DVT among neurodegenerative disorders (amyotrophic lateral sclerosis [ALS], Parkinson's disease [PD], multiple system atrophy [MSA], and progressive supranuclear palsy [PSP]-corticobasal syndrome [CBS]) and the risk factors for the development of DVT.

METHODS

Overall, 229 hospitalized patients with neurodegenerative diseases (65 patients with ALS, 61 with PD, 53 with MSA, and 50 with PSP-CBS) were included in this study. D-dimer value and ultrasonography of the leg vein were assessed to determine the presence or absence of leg DVT. We compared the DVT incidence among each disease group. To identify the risk factors for DVT, a multivariate analysis was performed.

RESULTS

Of 229 patients, 34 had leg DVT; the incidence was significantly higher in patients with PD (38%) than in those with ALS (2%), MSA (5%), or PSP-CBS (4%). Patients with DVT were older, had a smaller waist circumference, had a longer disease duration, and had a high blood pressure (BP) variability. Multivariate analysis revealed that a PD diagnosis and female sex, with a high BP variability were predictive of leg DVT.

CONCLUSIONS

Among the neurodegenerative diseases, the DVT incidence was markedly higher in PD than in ALS, MSA, and PSP-CBS. Several risk factors have been identified in patients with leg DVT. Recognition of these risk factors will improve patient care and guide the appropriate use of anticoagulants.

Evaluation of the ambulatory blood pressure monitoring in patients with retinal vein occlusion

BACKGROUND

Arterial hypertension (AHT) is the main risk factor for the development of retinal vein occlusion (RVO).

AIMS

To analyze the hypertensive profile with ambulatory blood pressure monitoring (ABPM) in patients with RVO.

PATIENTS AND METHODS

Retrospective and observational study of 66 patients with ABPM, 33 with retinal vein occlusion from a cohort of these disease and 33 controls without RVO, adjusted for age and sex.

RESULTS

Compared to controls, patients with RVO had elevated nocturnal values of SBP 130mmHg (21) vs. 119mmHg (11); P=.01 and DBP 73mmHg (11) vs. 65mmHg (9); P=.002. In addition, they presented a lower decrease in the Dipping ratio percentage 6.0% (10.4) vs. 12.3% (6.3); P=.005.

CONCLUSIONS

Patients with RVO have an unfavorable nocturnal hypertensive profile. Recognition of this fact can help optimize their treatment.

Association between retinal vein occlusion and early-stage hypertension: A propensity score analysis using a large claims database

BACKGROUNDS/OBJECTIVES

The threshold of hypertension was lowered from systolic blood pressure (SBP)/diastolic blood pressure (DBP) 140/90 mmHg to 130/80 mmHg by the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guideline. Thus, we investigated the association between retinal vein occlusion (RVO) occurrence and early-stage hypertension.

SUBJECTS/METHODS

This retrospective cohort study used the JMDC Claims Database (JMDC Inc., Tokyo, Japan) between 2005 and 2020. Individuals undergoing health checkups who had data on BP and did not take antihypertensive medications were included. They were classified into four BP groups: normal BP (SBP < 120 mmHg and DBP < 80 mmHg), elevated BP (SBP 120-129 mmHg and DBP < 80 mmHg), stage 1 hypertension (SBP 130-139 mmHg or DBP 80-89 mmHg), and stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). Date of RVO occurrence was defined as the first date of diagnosis. We estimated adjusted hazard ratios for RVO and central RVO using weighted Cox regression to adjust for potential confounders.

RESULTS

A total of 2,703,264 individuals were eligible. During a mean follow-up of 1,091 days, 3,526 RVO and 828 central RVO events occurred. The adjusted hazard ratios (95% confidence intervals) were 1.37 (1.19-1.57), 1.95 (1.75-2.18), and 3.33 (2.95-3.76) for RVO and 1.44 (1.07-1.93), 2.17 (1.72-2.73), and 3.76 (2.91-4.86) for central RVO in the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, compared with the normal BP group.

CONCLUSIONS

Even individuals with early-stage hypertension showed higher risks for RVO and central RVO than individuals with normal BP.

A new potential risk factor for central serous chorioretinopathy: blood pressure variability

BACKGROUND/OBJECTIVES

The choroid, mostly composed of vascular structures, can be directly affected by systemic hemodynamic changes. Blood pressure variability (BPV) may factor into choroidal dysfunction, which can be associated with the pathogenesis of central serous chorioretinopathy (CSCR). The aim of our study was to investigate short-term BPV over 24 h in patients with acute CSCR versus healthy controls.

SUBJECTS/METHODS

Our cross-sectional comparative study included 50 patients with CSCR (i.e., patient group) and 60 healthy individuals (i.e., control group). In all participants, 24-h ambulatory blood pressure was monitored every 15 min during the day and every 30 min at night. Mean variability index (VI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) during the day, at night, and across the 24-h period were subjected to statistical analyses.

RESULTS

Mean 24-h, daytime, and night-time SBP and DBP did not significantly differ between the groups. The mean 24-h and daytime VI values for SBP and DBP were significantly higher in the patient group than in the control group, whereas the mean night-time VI values for SBP and DBP between the groups were similar. Multivariate logistic regression models revealed that the VI values for 24-h and daytime SBP and DBP emerged as independent risk factors for developing CSCR.

CONCLUSION

Our study revealed that variabilities in 24-h, daytime SBP and DBP were significantly higher in patients with CSCR than in controls. Our results thus suggest that increased BPV may be a new risk factor for the development of CSCR.