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

doi:10.1016/j.exger.2019.01.009

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

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	14-24
Number of pages	11
Journal	Experimental Gerontology
Volume	119
Early online date	22 Jan 2019
DOIs	https://doi.org/10.1016/j.exger.2019.01.009
Publication status	Published - 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:
Copyright 2019 Elsevier B.V., All rights reserved.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

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

Access to Document

10.1016/j.exger.2019.01.009Licence: Unspecified

Cite this

@article{5a9cf0fec494457aad8bd9a987e979a1,

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

abstract = "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.",

keywords = "Blood pressure variability, Contrast sensitivity, End-organ damage, Eye, Orthostatic hypertension, Orthostatic hypotension",

author = "\{N{\'i} Bhuachalla\}, Bl{\'a}ith{\'i}n and McGarrigle, \{Christine A.\} and Neil O'Leary and Akuffo, \{Kwadwo Owusu\} and Tunde Peto and Stephen Beatty and Kenny, \{Rose Anne\}",

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: {\textcopyright} 2019 Elsevier Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

year = "2019",

month = may,

day = "1",

doi = "10.1016/j.exger.2019.01.009",

language = "English",

volume = "119",

pages = "14--24",

journal = "Experimental Gerontology",

issn = "0531-5565",

publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Orthostatic blood pressure variability is associated with lower visual contrast sensitivity function: Findings from The Irish Longitudinal Study on Aging

AU - Ní Bhuachalla, Bláithín

AU - McGarrigle, Christine A.

AU - O'Leary, Neil

AU - Akuffo, Kwadwo Owusu

AU - Peto, Tunde

AU - Beatty, Stephen

AU - Kenny, Rose Anne

N1 - 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: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - 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.

AB - 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.

KW - Blood pressure variability

KW - Contrast sensitivity

KW - End-organ damage

KW - Eye

KW - Orthostatic hypertension

KW - Orthostatic hypotension

U2 - 10.1016/j.exger.2019.01.009

DO - 10.1016/j.exger.2019.01.009

M3 - Article

C2 - 30677467

AN - SCOPUS:85060333258

SN - 0531-5565

VL - 119

SP - 14

EP - 24

JO - Experimental Gerontology

JF - Experimental Gerontology

ER -

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

Abstract

Bibliographical note

UN SDGs

Keywords

ASJC Scopus subject areas

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