Meta-analysis confirms tight blood pressure control lowers diabetic retinopathy risk
medwireNews: Meta-analysis data show that intensive blood pressure control significantly reduces the risk for developing diabetic retinopathy in patients with type 2 diabetes.
“These findings are important to healthcare practitioners, as accumulated evidence recommends that the strict blood pressure targets should be specifically tailored to these diabetic individuals with non-diabetic retinopathy,” say Jian-Bo Zhou (Capital Medical University, Beijing, China) and co-investigators.
By contrast, Zhou and team found that intensive blood pressure targeting did not significantly reduce the risk for progression of diabetic retinopathy or the incidence of proliferative diabetic retinopathy and macular edema.
They say that the reasons for the differential effect of strict blood pressure control on the incidence and progression of diabetic retinopathy are currently unclear, but might be due to differences in the definition of the progression or in baseline glycated hemoglobin levels among the trials.
The study included eight randomized controlled trials comparing intensive blood pressure control with conventional blood pressure control in 6989 patients with type 2 diabetes. Of these, 3749 were assigned to the former group and 3240 to the latter.
As reported in Diabetes Therapy, intensive blood pressure control was associated with a significant 17% reduction in the risk for developing diabetic retinopathy, with no heterogeneity detected among the trials.
These findings were confirmed by trial sequential analyses, which adjust the confidence intervals if data are sparse or repeatedly analyzed to reduce the risk for statistical errors, the researchers explain.
Zhou et al say the clinical implications of their study findings “should be emphasized.”
“Understanding whether diabetic individuals have a lower risk of [diabetic retinopathy] with the strict blood pressure targets will help diabetologists to provide effective clinical counseling for patients,” they write
“[Blood pressure] optimization should be done in primary care or by a diabetologist before the patients even see the ophthalmologist,” the researchers add.
By Laura Cowen
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