Key result
Elevated within-visit systolic blood pressure variability (SBPSD) was independently associated with an increased risk of diabetic retinopathy in patients with type 2 diabetes (OR 1.188).
Why the study?
It was unclear whether within-visit blood pressure variability increases the risk of diabetic retinopathy after adjusting for conventional metabolic risk factors.
Is elevated within-visit systolic blood pressure variability associated with an increased risk of diabetic retinopathy in patients with type 2 diabetes mellitus?
Case-Control (n=132)
Single-blind
No
Is elevated within-visit systolic blood pressure variability associated with an increased risk of diabetic retinopathy in patients with type 2 diabetes mellitus?
Odds Ratio: 1.188 (95% CI 1.03–1.37)
p-value: p=0.018
Elevated within-visit systolic blood pressure variability is an independent indicator of diabetic retinopathy in patients with type 2 diabetes, even when blood glucose is similarly controlled.
Should not yet inform DR risk stratification or management in T2DM; leaves open prospective validation of variability as a modifiable target.
Objective To discuss whether within-visit blood pressure variability (BPV) increases the risk of diabetic retinopathy (DR) after adjusting for the conventional metabolic risk factors and to evaluate the independent impact of BPV to DR in diabetic patients. Methods The study featured 625 patients with T2DM based on physical and biochemical tests. Among them, 66 patients had DR, and 66 HbA1c matched subjects without the condition (NDR group) were therefore handpicked from the remaining 559 participants in a ratio of 1:1. Three systolic BP (SBP) and diastolic BP (DBP) readings were recorded by physicians during a single medical assessment. Within-visit BPV for each subject was defined using the standard deviation of SBP (SBPSD) and DBP (DBPSD), coefficient of variation of SBP (SBPCV) and DBP (DBPCV). Results No significant differences were found in laboratory testing parameters as well as general clinical data between the two groups (P＞0.05), but cases of DR had higher SBPSD (2.88±2.41 vs 3.76±2.63, P=0.046) and SBPCV (1.92±1.63% vs 2.29±1.56%, P=0.036) than NDR subjects. SBPSD and SBPCV were both independent statistical indicators of DR after adjusting for age, gender, smoking history, alcohol consumption, obesity, history of hypertension, SBPM, DBPM, HbA1c and TC [OR: 1.188, 95%CI: 1.030-1.370, P=0.018 and OR: 1.271, 95%CI: 1.031-1.566, P=0.025, respectively]. Conclusion In T2DM patients, elevated within-visit SBPV associates strongly with DR in spite of no statistical difference in metabolic indicators. Even to the same degree of blood glucose control, within-visit SBPV is an independent indicator of DR.
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Gao et al. (2023) conducted a case-control in Diabetic Retinopathy in Type 2 Diabetes Mellitus (n=132). Within-visit systolic blood pressure variability vs. HbA1c-matched controls without diabetic retinopathy was evaluated on Presence of Diabetic Retinopathy (OR 1.188, 95% CI 1.030-1.370, p=0.018). Elevated within-visit systolic blood pressure variability (SBPSD) was independently associated with an increased risk of diabetic retinopathy in patients with type 2 diabetes (OR 1.188).
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