Bedeutung des 24-Stunden-Blutdruckprofils beim Glaukom

Zusammenfassung

Veränderungen des arteriellen Blutdrucks sind mit der Entstehung und Progression von Glaukomerkrankungen verbunden. Einige wesentliche Informationen lassen sich nur durch eine ambulante 24-Stunden-Blutdruckmessung erheben. Sie ist z. B. für die Diagnosesicherung bei Verdacht auf Weißkittelhypertonie unabdingbar und zeigt die Schwankungen des Blutdrucks im Tages- und Nachtverlauf. Der 24-Stunden-Mittelwert sollte unter 130/80 mmHg liegen, zu starke Abfälle des diastolischen Blutdrucks (unter 60 mmHg) in der Nacht stärken hingegen die Glaukomprogression. Ein Abfall des systolischen Blutdrucks in der Nacht von weniger als 10 % (Non-Dipper) oder um mehr als 20 % (Extrem-Dipper) verstärkt ebenfalls die Progression einer Glaukomerkrankung. Die Bedeutung des 24-Stunden-Blutdruckprofils bei der Kooperation von Ophthalmologen und Internisten wird diskutiert.

Abstract

The arterial blood pressure is an important determinant for the development and progression of glaucoma. Some relevant information can be obtained only by ambulatory 24-h blood pressure measurement (ABPM). White-coat hypertension can be excluded by ABDM and the variability of blood pressure during 24 hours can be assessed. 24-h mean blood pressure should be < 130/80 mmHg. In contrast, diastolic blood pressure values below 60 mmHg during the night have been identified as a progression factor in glaucoma, as well as reductions of night-time systolic blood pressure of less than 10 % (non-dipper) and of more than 20 % (extreme dipper). The significance of the 24-h blood pressure profile for the cooperation of ophthalmology and internal medicine is discussed.

Schlüsselwörter

Glaukom - Hypertonie - 24-Stunden-Blutdruckmessung

Key words

glaucoma - hypertension - ambulatory 24-h blood pressure measurement

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