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M. Javaheri, J. Chung, M. Torres, S. Azen, R. Klein, R. Varma, the LALES group; Blood Pressure and the Risk of Incident Diabetic Retinopathy in a Latino Population: The Los Angeles Latino Eye Study (LALES). Invest. Ophthalmol. Vis. Sci. 2009;50(13):4417.
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To determine the association between blood pressure and the four-year incidence of diabetic retinopathy (DR) in a population-based sample of Latinos with type 2 diabetes mellitus (T2DM).
The data for this analysis is derived from the Los Angeles Latino Eye Study (LALES), a population-based prevalence study of eye disease in Latinos (primarily Mexican-Americans) age 40 and older. Eight hundred ninety three participants underwent a comprehensive examination including measurement of systolic and diastolic blood pressure, glycosylated hemoglobin, stereoscopic fundus photographs ( 7 standard Early Treatment Diabetic Retinopathy Study fields) in addition to completing a standard in-home interview at baseline and a 4 year follow-up visit. Photographs were graded in a masked manner using a Modified Arlie House classification system to assess presence and severity of DR. Persons with a diagnosis of definite T2DM and no evidence of retinopathy at the baseline examination were included in this analysis. Univariate and multivariate analyses were used to identify if there was an independent relationship between blood pressure and the 4-year risk of developing DR.
Of the 1082 persons with diabetes mellitus a baseline, 544 had DR at baseline. Thus, 412 persons with T2DM were included in this analysis. The mean systolic and diastolic blood pressure in persons with DR was 127mmHg and 76mmHg. The mean systolic and diastolic blood pressure in persons without DR was 128mmHg and 76mmHg. These differences were not statistically significant (per 10mmHg systolic, OR=1.031 (0.905, 1.174), per 10mmHg diastolic, OR= 0.963 (0.769, 1.206), p≥0.44). Furthermore, in the multivariate model, after adjusting for age, glycosylated hemoglobin level, random blood glucose level, and body mass index, these differences were not significant.
Systolic and Diastolic blood pressures are not associated with a higher incidence of DR in our Latino population. While blood pressure control is important, it does not appear to play a significant role in the development of retinopathy in Latinos.
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