Chase H P, Garg S K, Jackson W E, Thomas M A, Harris S, Marshall G, Crews M J
Department of Pediatrics, University of Colorado Health Sciences Center, Denver.
Ophthalmology. 1990 Feb;97(2):155-9. doi: 10.1016/s0161-6420(90)32611-8.
The relationship between blood pressure and diabetic retinopathy was evaluated in 249 young subjects with type I diabetes. Although hypertension is known to be associated with an increased risk for retinopathy, the effects of high-normal blood pressure are unknown. Retinopathy (158 of 249 subjects, 63%) is considerably more common in a young diabetic population than is hypertension (7 of 249 subjects, 2%). Thus, if blood pressure is important in the etiology or progression of diabetic retinopathy, levels below the hypertensive range (less than 141/90 mmHg) must be considered. The combined effect of hypertension and high-normal blood pressure (greater than 90th percentile but less than 141/90 mmHg) was studied. Elevation in diastolic blood pressure, alone, and in combination with elevated systolic blood pressure, correlated significantly (P less than 0.03) with retinopathy. The presence of high-normal blood pressure resulted in a prospectively higher occurrence of retinopathy and of progression of preexisting retinopathy. Glycohemoglobin (HbA1) and duration of diabetes also correlated with retinopathy. Both good glycemic control and maintenance of diastolic blood pressure below the 90th percentile for age may be important in relation to diabetic retinopathy.
在249名1型糖尿病年轻受试者中评估了血压与糖尿病视网膜病变之间的关系。虽然已知高血压与视网膜病变风险增加有关，但血压略高于正常范围的影响尚不清楚。视网膜病变在年轻糖尿病患者中（249名受试者中有158名，占63%）比高血压（249名受试者中有7名，占2%）更为常见。因此，如果血压在糖尿病视网膜病变的病因或进展中起重要作用，那么必须考虑低于高血压范围（低于141/90 mmHg）的血压水平。研究了高血压和血压略高于正常范围（高于第90百分位数但低于141/90 mmHg）的联合作用。单独舒张压升高以及与收缩压升高相结合，均与视网膜病变显著相关（P<0.03）。血压略高于正常范围会导致视网膜病变的发生率以及既往存在的视网膜病变进展的发生率在预期中更高。糖化血红蛋白（HbA1）和糖尿病病程也与视网膜病变相关。良好的血糖控制以及将舒张压维持在年龄对应的第90百分位数以下，对于糖尿病视网膜病变可能都很重要。
