Turns out, people don’t like getting a needle stuck in their eye. Researchers have found a substantial increase in systolic blood pressure (BP) during intravitreal injections in some individuals. About 10% of patients had systolic BP spike to greater than 200mm Hg.
Despite the effectiveness and widespread use of anti–vascular endothelial growth factor therapy, its effect on systemic BP hasn’t been widely considered. Researchers recorded systolic and diastolic blood pressure, pulse rate and oxygen saturation before, during and after the intravitreal injection. Participants also completed an anxiety questionnaire. In 209 patients between the ages of 18 and 93 (92 women and 109 men), the mean systolic measurements increased from 150mm Hg to 162mm Hg after the preparation procedure and to 168mm Hg during the injection. The mean diastolic BP increased from 78mm Hg to 83mm Hg after the preparation procedure and to 83 mmHg during the injection.
Researchers believe that the possible blood pressure increase before the actual injection may constitute a risk factor for cardiovascular or cerebrovascular complications during treatment and could be relevant in patients at high risk for such events as well as in those receiving frequent injections. They conclude that further work could help determine whether these patients at risk should consider perioperative blood pressure monitoring or antihypertensive therapy.
|Berger V, Munk MR, Lersch F, et al. Association of intravitreal injections with blood pressure increase the following excitement and anxiety response under intravitreal injection study. JAMA Ophthalmol. November 1, 2018. [Epub ahead of print].|