ArticlePloS one2020
Hypertension, blood pressure control and diabetic retinopathy in a large population-based study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 4 of them syntheses that pooled it.
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Who cites it
64 citing papers in PubMed, 4 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review.Journal of clinical hypertension (Greenwich, Conn.) · 2025Pooled it
- Prevalence of diabetic retinopathy and its associated risk factors among adults in Ethiopia: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Determinants of diabetic retinopathy in Ethiopia: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Suboptimal blood pressure control and its associated factors among people living with diabetes mellitus in sub-Saharan Africa: a systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- Incidence and baseline predictors of discontinuation in DRCRnet studies.Eye (London, England) · 2026Article
- Article
- Prevalence and risk factors associated with diabetic retinopathy: a cross-sectional study in northern Xinjiang.Scientific reports · 2026Article
- Associations Between Initial Glycated Hemoglobin at Diabetes Diagnosis, Longitudinal Changes and Medication Effects, and the Severity and Progression of Sight-Threatening Diabetic Retinopathy.The Kaohsiung journal of medical sciences · 2026Article
- Retinal Ischemic Perivascular Lesions Screen for Vision-Threatening Diabetic Retinopathy Visualized on Ultra-Widefield Fluorescein Angiography.Translational vision science & technology · 2026Article
- Retinal Ischemic Perivascular Lesions are Associated with Multifactorial Disease Burden and Severity of Diabetic Retinopathy.Ophthalmology science · 2026Article
- Severity of hypertensive retinopathy and its determinants among adult patients attending ophthalmic centers in Northern Ethiopia: A multicenter cross-sectional study.BMC ophthalmology · 2026Article
- The role of blood pressure stability in diabetic retinopathy development.Eye (London, England) · 2026Article
- Diabetic retinopathy: why some eyes suffer more - a focus on retina-specific risk factors and metabolic memory.Journal of translational medicine · 2026Review
- Clinical implications of systolic blood pressure for diabetic retinopathy across HbA1c levels in a Japanese population.Scientific reports · 2026Article
- Impact of chronic kidney disease on the incidence of visual impairment and age-related eye diseases in a multi-ethnic Asian population.Journal of global health · 2025Article
- The Mechanisms of Inflammatory Factors and the Total Load of Cerebral Small Vessel Disease in Diabetic Retinopathy and Cognitive Impairment.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Association between haemoglobin levels and the risk of diabetic retinopathy in adults with type 2 diabetes: a retrospective cohort study using the TriNetX network.Eye (London, England) · 2025Article
- Prevalence, incidence, and risk factors of diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus.Journal of diabetes investigation · 2025Article
- The non-linear association between remnant cholesterol/high-density lipoprotein cholesterol ratio and diabetic retinopathy: a cross-sectional study in type 2 diabetic patients.Diabetology & metabolic syndrome · 2025Article
- Diabetic retinopathy screening using artificial intelligence and its predictors among people with type 2 diabetes mellitus in an urban area of Durgapur.Journal of family medicine and primary care · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical trials have shown beneficial effects of blood pressure (BP) control in reducing the risk of diabetic retinopathy (DR). However, association between BP control and DR in population-based studies is not clear. We aimed to examine the association of hypertension and BP control with DR.
methodsWe analysed data from a population-based cross-sectional study of Chinese, Malay and Indians adults with diabetes and hypertension (2004-2011, n = 2189, aged 40-80 years) in Singapore. DR severity was assessed from retinal photographs and graded for any- and vision-threatening DR (VTDR) using the modified Airlie House classification. Hypertension status was classified into (1) good control: on treatment (SBP < 130 and DBP < 80 mm Hg), (2) moderate control: on treatment, with BP levels other than group 1 and 3, (3) poor control: on treatment (SBP ≥140 and DBP ≥ 90 mm Hg), (4) untreated hypertension, any BP level. SBP, DBP and pulse pressure (PP) were analyzed as categories and as continuous variables. The association between BP and DR was assessed using multivariable logistic regression models.
resultsThe prevalence of any-DR and VTDR in the study population was 33.8% and 9.0% respectively. Both poorly controlled and untreated hypertension were significantly associated with any-DR with odds ratio (OR) (95% confidence interval [CI]) of 1.97 (1.39-2.83), and 2.01 [1.34-3.05]. Among BP components, SBP and PP were associated with both any-DR and VTDR with OR (95% CI) of 1.45 (1.28-1.65) and 1.61 (1.41-1.84) for any-DR, and 1.44 (1.19-1.76) and 1.67 (1.37-2.06) for VTDR.
conclusionIn a population-based sample of Asian adults with diabetes and hypertension, treated but poorly controlled as well as untreated hypertension were significantly associated with any-DR. Among the BP components, higher SBP and PP levels were associated with both any-DR and VTDR. Further longitudinal studies are necessary to confirm our findings.
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