Low blood pressure (hypotension) has been previously linked to normotensive glaucoma, and this association has led some to erroneously believe that high blood pressure (hypertension) could be protective against glaucoma. In fact, there may be a negative association between glaucoma and hypertension, as suggested by Kuang and colleagues. The idea that one health condition can decrease our risks for another is nice to hope for, but is likely not true. Any deviation from a state of health will likely have net negative consequences across the board. Could both high and low blood pressure be glaucoma risk factors? Probably so.
The mechanism for hypotension’s association with glaucoma is thought to be decreased ocular perfusion pressure. Hypertension on the other hand may increase aqueous production and ultimately increase IOP. Stay tuned, as specific mechanisms are poorly understood.
The associations of both hypotension and possibly hypertension with glaucoma suggests that a healthy lifestyle where blood pressure is normal is ideal. We must be proactive and measure the blood pressure of glaucoma patients, as it is a symptomless systemic disease. Further, family physicians should also be informed and encouraged to send hypertensive patients for ocular evaluation just as they send diabetic patients for annual screening.
https://www.healio.com/news/optometry/20200630/systemic-hypertension-associated-with-primary-open-angle-glaucoma
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