24-Hour Intraocular Pressure and Blood Pressure Levels with Latanoprost/Timolol Fixed Combination Versus Timolol

Purpose: To evaluate 24-hr intraocular pressure (IOP) and blood pressure (BP) with timolol or latanoprost/timolol fixed combination (LTFC). Methods: Patients with primary open-angle glaucoma or ocular hypertension with normal blood pressure were randomized to LTFC, dosed each evening, or timolol dosed twice daily in a cross-over design for 8 weeks and the opposite medicine for 8 weeks. IOP was measured at 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours in the sitting position with Goldmann applanation tonometry and BP monitoring every 30 min while awake and every hour while asleep at the end of each 8-week treatment period. Results: Twenty-nine patients had a 24-hr baseline IOP of 26.3 ± 2.5 mmHg, systolic BP (SBP) of 121.4 ± 12.4 mmHg, diastolic BP (DBP) 72.9 ± 7.1 mmHg, and ocular perfusion pressure (OPP) of 33.9 ± 5.7 mmHg. No statistical differences were found between untreated and treated 24-hr SBP, DBP, mean BP (MBP), heart rate, or nocturnal BP dipping status with either medication. LTFC lowered IOP more at each timepoint compared to timolol (difference between treatments 2.7 mmHg, p = 0.0002). Conclusions: Neither timolol or evening-dosed LTFC reduced SBP, DBP, MBP, OPP, or increased nocturnal dipping. LTFC was more effective than timolol in decreasing IOP.