Association between systolic blood pressure and diabetic retinopathy in both hypertensive and normotensive patients with type 2 diabetes: risk factors and healthcare implications

Li, Y.-T. et al. (2021) Association between systolic blood pressure and diabetic retinopathy in both hypertensive and normotensive patients with type 2 diabetes: risk factors and healthcare implications. Healthcare, 9(5), 580. (doi: 10.3390/healthcare9050580) (PMID:34068355) (PMCID:PMC8153301)

Abstract

A common diabetes-related microvascular complication is diabetic retinopathy (DR), yet associations between blood pressure (BP) and risks for DR in diabetic patients with normal BP received inadequate attention. This may lead to ‘clinical inertia’ in early DR prevention. We aimed to assess whether the extent to which systolic BP levels were associated with DR in patients with type 2 diabetes (T2DM) and normal BP were similar to that in those with concurrent hypertension. Data were collected from patients with T2DM attending ophthalmic check-up with primary care referral (n = 2510). BP measurements, clinical laboratory tests, and dilated fundus examination were conducted according to gold standard of diagnosis and routine clinical procedure. Of all subjects, over 40% were normotensive and one fifth were clinically diagnosed with DR. Systolic BP levels increased across DR categories of escalated severity irrespective of the coexistence of hypertension. Ordinal logistic regression analysis showed that an increased systolic BP was independently and significantly associated with DR (adjusted odds ratio [aOR] = 1.020, p < 0.001 for hypertensives; aOR = 1.019, p = 0.018 for normotensives), after adjusting for diabetes duration, sex, lifestyles, and haemoglobin A1c levels. Regular monitoring of systolic BP should not be neglected in routine diabetes management even when BP falls within the normal range.

• Item Type: Articles
• Additional Information: Funding: This work was supported by the National Natural Science Foundation of China [Grant Numbers 71673309, 71904212]; Open Research Funds of the State Key Laboratory of Ophthalmology [Grant Number 303060202400362]; Science and Technology Development Fund of Guangdong Province [Grant Number 2016A020216006]; Special Support Program of Guangdong Province [Grant Number 2017TQ04R749]; Basic and Applied Basic Research Foundation of Guangdong Province [Grant Number 2019A1515011381]; and Higher Education Reform Project of Guangdong Province [Grant Number 20191206-20].
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wang, Professor Haoxiang

Creator Roles

Wang, H. H.X.: Conceptualization, Methodology, Supervision, Writing – original draft

• Authors: Li, Y.-T., Wang, Y., Hu, X.-J., Chen, J.-H., Li, Y.-Y., Zhong, Q.-Y., Cheng, H., Mohammed, B. H., Liang, X.-L., Hernandez, J., Huang, W.-Y., and Wang, H. H.X.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Healthcare
• Publisher: MDPI
• ISSN: 2227-9032
• ISSN (Online): 2227-9032
• Published Online: 13 May 2021
• Copyright Holders: Copyright © 2021 by the authors
• First Published: First published in Healthcare 9(5):580
• Publisher Policy: Reproduced under a Creative Commons Licence