Association between Systemic Hypertension and Ocular Perfusion Pressure in an Adult Population of North Karnataka, India: A Cross-sectional Study

Introduction: Glaucoma, a major cause of irreversible blindness, is influenced by Intraocular Pressure (IOP) and ocular blood flow. Systemic hypertension may affect the risk of developing glaucoma by influencing Ocular Perfusion Pressure (OPP), although this relationship remains complex and not fully understood. Nocturnal hypotension, especially in individuals on antihypertensive treatment, may further compromise optic nerve perfusion. There is limited data on this association, warranting a focused investigation. Aim: To evaluate the impact of blood pressure on OPP in the adult population of North Karnataka. Materials and Methods: A cross-sectional study was conducted at the Department of Ophthalmology, BLDE (DU) SBPMC, Vijayapura, Karnataka, India, involving 168 participants (84 hypertensives and 84 normotensives) from May 2023 to December 2024. Comprehensive eye examinations, including the measurement of IOP and fundus evaluation, were performed. Blood pressure was recorded at 7 am, 1 pm, 6 pm and 12 am. OPP values—Mean Ocular Perfusion Pressure (MOPP), Systolic Perfusion Pressure (SPP), and Diastolic Perfusion Pressure (DPP)—were calculated. Statistical analysis included Chisquare, Mann-Whitney U, Spearman’s rho, and Kruskal-Wallis tests (p-value <0.05). Results: Hypertensive participants exhibited significantly (p-value <0.05) higher IOP and OPP at all time intervals. Peak values were observed at 1 pm and 6 pm. OPP correlated positively (r value=+0.7 to +0.91, p-value=0.001) with systolic, diastolic, and mean arterial pressure at each time point in hypertensives. Antihypertensive medications significantly influenced OPP (p-value=0.01). Conclusion: Individuals with hypertension demonstrated elevated OPP and IOP, suggesting an increased risk of glaucoma. Regular screening and integrated management of blood pressure and ocular parameters are crucial for the prevention of glaucoma.