Orthostatic blood pressure variability is associated with lower visual contrast sensitivity function: Findings from The Irish Longitudinal Study on Aging

Bláithín Ní Bhuachalla, Christine A. McGarrigle*, Neil O'Leary, Kwadwo Owusu Akuffo, Tunde Peto, Stephen Beatty, Rose Anne Kenny

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Hypertension is established to cause vascular end-organ damage. Other forms of dysregulated blood pressure (BP) behaviour, such as orthostatic hypotension have also been associated with cardiovascular (CV) events. The eye is potentially vulnerable to dysregulated systemic BP if ocular circulation autoregulation is impaired. We investigated whether phenotypes of abnormal BP stabilisation after orthostasis, an autonomic stressor, had a relationship with contrast sensitivity (CS), an outcome measure of subtle psychophysical visual function. Methods: This was a cross-sectional study from wave 1 of The Irish Longitudinal Study on Ageing (TILDA). From beat-to-beat orthostatic BP (BP), measured by digital photoplethysmography during active stand, 4 phenotypes have been defined 1) normal stabilisation 2) orthostatic hypotension, 3) orthostatic hypertension 4) BP variability. Contrast sensitivity was measured using a Functional Visual Analyzer. Multivariable linear regression models investigated the relationship between orthostatic BP phenotypes and contrast sensitivity in 4289 adults aged ≥50 years adjusting for, demographics, cardiovascular risk factors, self-reported eye pathologies, objective hypertension and antihypertensives. A sensitivity analysis adjusted for age-related macular degeneration, glaucoma, diabetic retinopathy and maculopathy identified on retinal photographs. Finally models were compared, adjusting for alternative measures of cataract versus not, to examine the potential effect of cataract on any associations. Results: Systolic orthostatic BP variability was associated with worse contrast sensitivity, in the primary and the sensitivity analysis. Adjusting for alternative measures of clinical cataract attenuated the association by 18%. Conclusions: Orthostatic BP variability is associated with worse contrast sensitivity, independent of hypertension and retinal pathology and may be a cardiovascular biomarker of early ocular pathology.

Original languageEnglish
Pages (from-to)14-24
Number of pages11
JournalExperimental Gerontology
Early online date22 Jan 2019
Publication statusPublished - 01 May 2019

Bibliographical note

Funding Information:
The authors report no conflicts of interest. Informed consent was obtained for all participants, and all protocols and procedures were approved by the institutional review board. TILDA is funded by The Atlantic Philanthropies (research grant), Irish Life plc and the Irish Government (research grant). Dr. Peto was funded by the NIHR BMRC at Moorfields Eye Hospital Foundation Trust and the UCL Institute of Ophthalmology. No funder played a role in the design, execution, analysis and interpretation of data or in the writing of this paper. The authors would like to thank all the participants in the study, the TILDA research, the team of interviewers and the study nurses and administrators.

Publisher Copyright:
© 2019 Elsevier Inc.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Blood pressure variability
  • Contrast sensitivity
  • End-organ damage
  • Eye
  • Orthostatic hypertension
  • Orthostatic hypotension

ASJC Scopus subject areas

  • Biochemistry
  • Ageing
  • Molecular Biology
  • Genetics
  • Endocrinology
  • Cell Biology

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