Klein R, Klein B E, Moss S E, Davis M D, DeMets D L
Department of Ophthalmology, University of Wisconsin Medical School, Madison.
Arch Intern Med. 1989 Nov;149(11):2427-32.
The relationship between blood pressure and the 4-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Younger- (n = 891) and older-onset (n = 987) persons participating in baseline and follow-up examinations were included. Blood pressure was measured using the Hypertension Detection and Follow-up Program protocol. Retinopathy was determined from stereoscopic fundus photographs. In the younger-onset group, comparing the highest with the lowest quartile of systolic blood pressure, the relative risk for developing any diabetic retinopathy was 1.8 and for diastolic blood pressure it was 1.2; for progression of diabetic retinopathy, it was 1.1 and 1.3 for systolic and diastolic blood pressure, respectively. After controlling for other risk variables, systolic blood pressure remained a significant predictor of the incidence of diabetic retinopathy; diastolic blood pressure was of borderline significance in predicting progression in the younger-onset group. Blood pressure was not related to incidence or progression of retinopathy either in the older-onset group using insulin or the older-onset group not using insulin.
在威斯康星州开展的一项基于人群的研究中，对血压与糖尿病视网膜病变4年发病率及病情进展之间的关系进行了调查。研究纳入了参与基线和随访检查的早发型（n = 891）和晚发型（n = 987）人群。血压采用高血压检测与随访项目方案进行测量。视网膜病变通过立体眼底照片确定。在早发型组中，将收缩压最高四分位数与最低四分位数相比较，发生任何糖尿病视网膜病变的相对风险为1.8，舒张压的相对风险为1.2；对于糖尿病视网膜病变的进展，收缩压和舒张压的相对风险分别为1.1和1.3。在对其他风险变量进行控制后，收缩压仍然是糖尿病视网膜病变发病率的显著预测因素；舒张压在预测早发型组病情进展方面具有临界显著性。在使用胰岛素的晚发型组或未使用胰岛素的晚发型组中，血压与视网膜病变的发病率或病情进展均无关联。
