Hypertension and Diabetic Retinopathy

Abstract

Diabetic retinopathy is the most specific microangiopathy related to diabetes. Furthermore, hypertension is frequently associated with diabetes. The aim of our study was to analyze the prevalence of diabetic retinopathy in hypertensive diabetic patients. Our descriptive retrospective study was conducted in 125 diabetic patients hospitalized in our department. Each patient had a complete clinical examination, a standard biological assessment and fundus to evaluate possible retinal involvement. The age was 53.78 ± 11.2 years, 24.6% were smokers. The mean duration of diabetes progression was 11 ± 7.41 years, HbA 1c = 8.9 ± 3.19%. Overweight or obesity was found in 49.9% of patients. Among our hypertensive patients, 46.9% received a monotherapy and 36.2% a dual therapy. Angiotensin converting enzyme inhibitors were the most prescribed (38.1%) followed by diuretics (19.1%). The most common association was an angiotensin II receptor antagonist + a diuretic (59% of associations). Diabetic retinopathy was found in 47% of patients. 36% of patients suffered from mild non-proliferative diabetic retinopathy (NPDR), 27% from moderate NPDR, 25% from severe NPDR and 12% from proliferative diabetic retinopathy. Maculopathy was present in 7.2% of cases. Complicated diabetic retinopathy was present in 1.7% of cases, and 5% of patients had a Laser treatment for retinopathy. Uncontrolled glycaemia and blood pressure have a synergistic effect on the development and progression of diabetic retinopathy. In addition to glycemic control, the management of hypertension is essential to prevent its onset and slow its progression.