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      Elevated blood pressure is associated with higher prevalence of low visual acuity among adolescent males in Northeast China

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          Abstract

          The purpose of this study is to track the trends of low visual acuity (VA) from 2005 to 2014, and to investigate its associations with systemic blood pressure (BP) components among adolescents in Northeast China. A total of 55320 students of Han nationality aged 13 to 18 years were included. There has been a significant increase in the prevalence of low VA, with 31.3% in 2005, 40.2% in 2010 and 43.4% in 2014. In multivariable-adjusted logistic regression models, each 1-mm Hg increment in systolic BP (SBP) was associated with 0.8% (95% confidence interval [CI]: 0.1–1.6%), 0.5% (95% CI: 0.1–0.9%) and 1.1% (95% CI: 0.6–1.6%) increased odds of low VA for males in 2005, 2010 and 2014; each 1-mm Hg increment in pulse pressure (PP) was associated with 1.6% (95% CI: 0.7–2.5%), 0.8% (95% CI: 0.4–1.2%) and 1.2% (95% CI: 0.7–1.7%) increased odds of low VA. Higher PP categories had greater odds for low VA compared with the reference group. Similar associations were not observed for females. We conclude that higher prevalence of low VA was significantly associated with higher SBP and PP in males. Furthermore, there was a dose-dependent association between the prevalence of low VA and the levels of PP.

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          The impact of ocular blood flow in glaucoma.

          Josef Flammer, Selim Orgül, Vital P. Costa … (2002)
          Two principal theories for the pathogenesis of glaucomatous optic neuropathy (GON) have been described--a mechanical and a vascular theory. Both have been defended by various research groups over the past 150 years. According to the mechanical theory, increased intraocular pressure (IOP) causes stretching of the laminar beams and damage to retinal ganglion cell axons. The vascular theory of glaucoma considers GON as a consequence of insufficient blood supply due to either increased IOP or other risk factors reducing ocular blood flow (OBF). A number of conditions such as congenital glaucoma, angle-closure glaucoma or secondary glaucomas clearly show that increased IOP is sufficient to lead to GON. However, a number of observations such as the existence of normal-tension glaucoma cannot be satisfactorily explained by a pressure theory alone. Indeed, the vast majority of published studies dealing with blood flow report a reduced ocular perfusion in glaucoma patients compared with normal subjects. The fact that the reduction of OBF often precedes the damage and blood flow can also be reduced in other parts of the body of glaucoma patients, indicate that the hemodynamic alterations may at least partially be primary. The major cause of this reduction is not atherosclerosis, but rather a vascular dysregulation, leading to both low perfusion pressure and insufficient autoregulation. This in turn may lead to unstable ocular perfusion and thereby to ischemia and reperfusion damage. This review discusses the potential role of OBF in glaucoma and how a disturbance of OBF could increase the optic nerve's sensitivity to IOP.
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            Trends in blood pressure among children and adolescents.

            Paul Muntner, Jiang He, Jeffrey A Cutler … (2004)
            The prevalence of overweight among children and adolescents increased between 1988 and 2000. The change in blood pressure among children and adolescents over that time and the role of overweight is unknown. To examine trends in systolic and diastolic blood pressure among children and adolescents between 1988 and 2000. Two serially conducted cross-sectional studies using nationally representative samples of children and adolescents, aged 8 to 17 years, from the third National Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994 (n = 3496) and NHANES 1999-2000 (n = 2086). Systolic and diastolic blood pressure levels. In 1999-2000, the mean (SE) systolic blood pressure was 106.0 (0.3) mm Hg and diastolic blood pressure was 61.7 (0.5) mm Hg. After adjustment for age, mean systolic blood pressure was 1.6 mm Hg higher among non-Hispanic black girls (P =.11) and 2.9 mm Hg higher among non-Hispanic black boys (P<.001) compared with non-Hispanic whites. Among Mexican Americans, girls' systolic blood pressure was 1.0 mm Hg higher (P =.21) and boys' was 2.7 mm Hg higher (P<.001) compared with non-Hispanic whites (P<.001). With further adjustment for body mass index, these differences were attenuated. After age, race/ethnicity, and sex standardization, systolic blood pressure was 1.4 (95% confidence interval [CI], 0.6-2.2) mm Hg higher (P<.001) and diastolic blood pressure was 3.3 (95% CI, 2.1-4.5) mm Hg higher in 1999-2000 (P<.001) compared with 1988-1994. With further adjustment for differences in the body mass index distribution in 1988-1994 and 1999-2000, the increase in systolic blood pressure was reduced by 29% and diastolic blood pressure was reduced by 12%. Blood pressure has increased over the past decade among children and adolescents. This increase is partially attributable to an increased prevalence of overweight.
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              Blood flow in the optic nerve head and factors that may influence it.

              Sohan Hayreh (2001)
              In the recent past there has been great interest in the blood supply of the optic nerve head (ONH), how to evaluate ONH blood flow, and what factors influence it, in health and disease. This is because evidence has progressively accumulated that there is vascular insufficiency in the ONH in both anterior ischemic optic neuropathy (AION) and glaucomatous optic neuropathy (GON)-two major causes of blindness or of seriously impaired vision in man. For the management and prevention of visual loss in these two disorders, a proper understanding of the factors that influence the blood flow in the ONH is essential. The objective of this paper is, therefore, to review and discuss all these factors. The various factors that influence the vascular resistance, mean blood pressure and intraocular pressure are discussed, to create a better basic understanding of the ONH blood flow, which may help us toward a logical strategy for prevention and management of ischemic disorders of the ONH.
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                Author and article information

                Contributors
                Yingxian Sun: yxsun@cmu.edu.cn
                Jue Li: mmz_1989@163.com
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 22 November 2017
                Publication date PMC-release: 22 November 2017
                Publication date Collection: 2017
                Volume: 7
                Electronic Location Identifier: 15990
                Affiliations
                [1 ]ISNI 0000000123704535, GRID grid.24516.34, Key Laboratory of Arrhythmias of Ministry of Education of China, Tongji University School of Medicine, ; Shanghai, China
                [2 ]ISNI 0000000123704535, GRID grid.24516.34, Institute of Clinical Epidemiology, Tongji University School of Medicine, ; Shanghai, China
                [3 ]ISNI 0000 0001 0742 0364, GRID grid.168645.8, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, ; Worcester, MA USA
                [4 ]ISNI 0000 0004 1806 3501, GRID grid.412467.2, Department of Clinical Epidemiology, , Library, Shengjing Hospital of China Medical University, ; Shenyang, Liaoning China
                [5 ]ISNI 0000 0000 9549 5392, GRID grid.415680.e, Department of Cardiology, , the Second Hospital Affiliated to Shenyang Medical College, ; Shenyang, Liaoning China
                [6 ]GRID grid.412636.4, Department of Cardiology, , the First Hospital of China Medical University, ; Shenyang, Liaoning China
                Article
                Publisher ID: 14252
                DOI: 10.1038/s41598-017-14252-9
                PMC ID: 5700107
                PubMed ID: 29167436
                SO-VID: 53ba9d1e-334d-47fc-a95d-50ffbdc4927d
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 7 February 2017
                Date accepted : 9 October 2017
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2017

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