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. 2025 Jul 1;15(1):22092.
doi: 10.1038/s41598-025-05639-0.

The arterial stiffness and pulse pressure are predictors of intraocular pressure in a middle-aged population

Alexandre Vallée  1   2 , Antoine Labbé  3   4   5   6   7 , Maxence Arutkin  8   9 , Christophe Baudouin  3   4   5   6   7 , Jean-Noël Vallée  5   6   7   10
Affiliations

The arterial stiffness and pulse pressure are predictors of intraocular pressure in a middle-aged population

Alexandre Vallée et al. Sci Rep. .

Abstract

The vascular theory posits that glaucoma is associated to ocular blood flow alterations. However, there is uncertainty regarding the association of arterial stiffness index (ASI) and pulse pressure (PP) to intraocular pressure (IOP). This study investigates the relationship between ASI and PP, and IOP, using the UK Biobank population. Among 89,930 participants of the UK Biobank population, ASI and PP were assessed, and their correlations with IOP were estimated using multiple linear and logistic regressions adjusted for age, sex, BMI, diabetes, dyslipidemia, mean blood pressure, heart rate, tobacco smoking status, previous CV diseases and antihypertensive therapy. Youden indices were determined for ASI at a value of 9.41 m/s and for PP at 49.18 mmHg to determine IOP > 21mmHg. After adjustment for all covariates, ASI > 9.41 m/s was significantly correlated with IOP levels, B = 0.054 [0.031; 0.076] and with IOP > 21 mmHg, OR = 1.057 [1.004-1.113]. PP > 49.18 mmHg was significantly associated with IOP levels, B = 0.378 [0.345; 0.401] and with IOP > 21 mmHg, OR = 1.558 [1.474-1.648]. Similar results were observed when considering ASI and PP at continuous levels. When considering participants with IOP < 21 mmHg (N = 83,079), ASI > 9.41 m/s and PP > 49.18 mmHg were significantly associated with IOP levels, B = 0.015 [0.008; 0.021], B = 0.286 [0.266; 0.306], respectively. We demonstrated that increased ASI and PP levels are associated with increased IOP. These findings provide new insight into the vascular theory between IOP and ASI.

Keywords: Arterial stiffness; Arterial stiffness index; Atherosclerotic pulse pressure; Glaucoma; Intraocular pressure.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics of approval statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Northwest – Haydock Research Ethics Committee (protocol code: 21/NW/0157, date of approval: 21 June 2021). Patient consent statement: Written informed consent has been obtained from the patients.

Figures

Fig. 1
Fig. 1
Flowchart.
Fig. 2
Fig. 2
Univariable linear regressions between ASI and PP with IOP in overall study population and according to IOP levels status.
Fig. 3
Fig. 3
Univariable linear regressions between ASI and PP with IOP in population according to glaucoma status and IOP levels status.
See this image and copyright information in PMC

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