Background: Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. Hypertension may worsen DR risk due to additional vascular damage. We aimed to investigate whether hypertension could increase the 10-year incidence of DR in type 2 diabetes (T2DM) patients.

Method: We included T2DM individuals who were free of DR at baseline, completed at least one further clinic visit from 1997 to 2008, and followed up for ten years. Patients were categorized into normotension or hypertension based on the clinician’s diagnosis. The retinal photograph was taken annually. The Kaplan-Meier curve was used to estimate the cumulative incidence of DR, stratified by normotensive/hypertensive status. Log-rank test was used to compare the distribution of time until the occurrence of DR in two groups. A p-value <0.05 was considered statistically significant.

Results: After a median follow-up duration of 61 months, cumulative incidences of DR among normotensive and hypertensive participants were 49% (95% CI 36%-60%) and 73% (95% CI 67%-78%), respectively. There was a significant difference in the risk of new-onset DR among groups (p <0.001). The gap between the two Kaplan-Meier curves occurred early in the first year after recruiting (Figure).

Conclusion: Hypertension could further increase the risk of DR among type 2 diabetes patients. An effective strategy of DR screening is recommended for patients coexisting with hypertension.


N.Nguyen: None. N.Khue: None.

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