Blood pressure control for diabetic retinopathy

Sleilati, Gina; Frank, Robert N.; Mathew, Milan C

doi:10.1002/14651858.cd006127

Cited by 2 publications

(2 citation statements)

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“…The protocol for this review did not specify subgroup analyses for participants with type 1 and type 2 diabetes and for participants characterized by blood pressure levels at baseline (Sleilati 2009). The decision to examine findings in these subgroups was made after we began screening the results of electronic searches.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetic retinopathy is a substantial public health problem (Zhang 2010). Because studies of retinal physiology suggest a role for blood pressure in pathological changes in diabetic retinopathy (Sjølie 2011), a systematic review of the effectiveness of blood pressure control with respect to diabetic retinopathy is warranted (Sleilati 2009). …”

Section: Introductionmentioning

confidence: 99%

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Blood pressure control for diabetic retinopathy

Diana

Wang

Vedula

et al. 2015

Cochrane Database of Systematic Reviews

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120

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BACKGROUND: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. OBJECTIVES: The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of antihypertensive medications with respect to the same outcomes. METHODS:Search methods: We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria: We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of antihypertensive agents versus placebo. Data collection and analysis: Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life, and cost-effectiveness at annual intervals after study entry whenever provided in published reports and other documents available from included trials. MAIN RESULTS: We included 15 RCTs, conducted primarily in North America and Europe, that had enrolled 4157 type 1 and 9512 type 2 diabetic participants, ranging from 16 to 2130 participants in individual trials. In 10 of the 15 RCTs, one group of participants was assigned to one or more anti-hypertensive agents and the control group received placebo. In three trials, intense blood pressure control was compared to less intense blood pressure control. In the remaining two trials, blood pressure control was compared with usual care. Five of the 15 trials enrolled type 1 diabetics, and 10 trials enrolled type 2 diabetics. Six trials were sponsored

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Section: Discussionmentioning

confidence: 99%