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Clinical Autonomic Research
Published in: Clinical Autonomic Research 6/2015

01-12-2015 | Research Article

Phenotypes of orthostatic blood pressure behaviour and association with visual acuity

Authors: Bláithín Ní Bhuachalla, Christine A. McGarrigle, Kwadwo Owusu Akuffo, Tunde Peto, Stephen Beatty, Rose Anne Kenny

Published in: Clinical Autonomic Research | Issue 6/2015

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Abstract

Background

Manifestations of neurocardiovascular instability (NCVI), including orthostatic hypotension (OH) orthostatic hypertension (OHTN) and impaired blood pressure variability (BPV), have been associated with cardiovascular (CV) events. The eye is highly vascular and we propose an ideal target end organ to investigate pathological implications of NCVI.

Objective

To identify and define clinically applicable phenotypes of orthostatic blood pressure (BP) behaviour, analogous to OH, OHTN, and orthostatic BPV and to investigate their relationship to vision.

Methods

Wave one data from the Irish Longitudinal Study on Ageing (TILDA) were used. Orthostatic BP (OBP) phenotypes were identified and defined from beat-to-beat BP data, measured by digital photoplethysmography during an active stand (AS) lasting 110 s (s). Visual acuity (VA) was assessed using the Early Treatment Diabetic Retinopathy Study (EDTRS) LogMAR chart. The relationship between OBP phenotypes and VA in 4355 adults aged ≥50 years was investigated through multivariate linear regression models.

Results

There was a wide fluctuation in the prevalence of OH and OHTN up to 20 s after standing. After 30 s, four distinct OBP phenotypes were identified: in 70 % BP stabilised to within 20/10 mmHg of baseline BP, 4 % had persistent OH, 2 % had persistent OHTN and 25 % had exaggerated orthostatic blood pressure variability BPV. Systolic BPV was associated with worse VA (P = 0.02) as was diastolic BPV (P = 0.03), following adjustment for demographics, health behaviours, self-report eye diseases and diabetes, uncorrected refractive error, objective hypertension and antihypertensives.

Conclusions

The hypothesis that NCVI may independently modulate CV risk is supported the independent association of exaggerated BPV and worse VA.
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Metadata
Title
Phenotypes of orthostatic blood pressure behaviour and association with visual acuity
Authors
Bláithín Ní Bhuachalla
Christine A. McGarrigle
Kwadwo Owusu Akuffo
Tunde Peto
Stephen Beatty
Rose Anne Kenny
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 6/2015
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0315-9

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