Association of hypertension and dyslipidemia with progression of DR (Diabetic Retinopathy).
DOI:
https://doi.org/10.51168/sjhrafrica.v6i9.2222Keywords:
Diabetic Retinopathy, Hypertension, Dyslipidemia, Diabetes Mellitus, Risk FactorsAbstract
Background
Diabetic Retinopathy (DR) is a major microvascular complication of Diabetes Mellitus (DM) and a leading cause of vision loss. Hypertension and dyslipidemia have been identified as modifiable risk factors that may accelerate DR progression.
Methodology
A hospital-based cross-sectional study was conducted among 200 diabetic patients at G.M.C.H., Purnea, from January to December 2024. Participants underwent clinical, ophthalmic, and laboratory evaluations. DR was graded using the ETDRS classification. Lipid abnormalities and hypertension were assessed as per standard guidelines. Data were analyzed using SPSS version 25
Results
The prevalence of DR was 43%. Hypertension (61%) and dyslipidemia (54%) were significantly associated with DR (p < 0.05). Patients with both conditions showed a higher frequency of moderate-to-severe DR. Logistic regression revealed hypertension (OR 2.41, p = 0.006) and dyslipidemia (OR 1.97, p = 0.032) as independent predictors, with combined presence increasing risk more than threefold (OR 3.64, p = 0.002).
Conclusion
Hypertension and dyslipidemia are significant risk factors for the progression of diabetic retinopathy. Comprehensive management of blood pressure, lipid profile, and glycemic control is essential to reduce vision-threatening complications in diabetic patients.
Recommendation
Regular screening for lipid and blood pressure abnormalities should be integrated into diabetes care programs to prevent or slow DR progression.
References
World Health Organization. World Report on Vision. Geneva: WHO; 2023.
Yau JWY, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556-564. https://doi.org/10.2337/dc11-1909
Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010;376(9735):124-136. https://doi.org/10.1016/S0140-6736(09)62124-3
Zhang X, Saaddine JB, Chou CF, et al. Prevalence of diabetic retinopathy in the United States, 2005-2008. BMJ Open Diabetes Res Care. 2017;5(1):e000437.
Raman R, Rani PK, Gnanamoorthy P, et al. Risk factors for diabetic retinopathy in self-reported type 2 diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 2). Indian J Ophthalmol. 2020;68(Suppl 1): S36-S41.
Wong TY, Klein R, Klein BEK, et al. Retinal vessel diameters and their associations with age and blood pressure. N Engl J Med. 2008;359:221-232.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703-713. https://doi.org/10.1136/bmj.317.7160.703
van Hecke MV, Dekker JM, Nijpels G, et al. Inflammation and endothelial dysfunction are associated with retinopathy: the Hoorn Study. Diabetologia. 2009;52(7):1199-1209.
Stratton IM, Kohner EM, Aldington SJ, et al. UKPDS 50: risk factors for incidence and progression of retinopathy in type 2 diabetes over 6 years. Diabetologia. 2001;44(2):156-163. https://doi.org/10.1007/s001250051594
Miller RG, Anderson SJ, Costacou T, et al. Risk factors for proliferative diabetic retinopathy in the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care. 2013;36(9):2610-2617.
Chew EY, Davis MD, Danis RP, et al. The effects of medical management on the progression of diabetic retinopathy in persons with type 2 diabetes: The ACCORD Eye Study. Ophthalmology. 2014;121(12):2443-2451. https://doi.org/10.1016/j.ophtha.2014.07.019
Sasongko MB, Wong TY, Nguyen TT, et al. Serum apolipoproteins are associated with systemic and retinal microvascular function in type 2 diabetes. Ophthalmology. 2011;118(5):1033-1039.
Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study). Lancet. 2007;370:1687-1697. https://doi.org/10.1016/S0140-6736(07)61607-9
ACCORD Eye Study Group. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010;363(3):233-244. https://doi.org/10.1056/NEJMoa1001288
Rema M, Premkumar S, Anitha B, et al. Prevalence of diabetic retinopathy in urban India: The Chennai Urban Rural Epidemiology Study (CURES) Eye Study, I. Diabet Med. 2005;22(8):1141-1148. https://doi.org/10.1167/iovs.05-0019
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IV. Diabetic retinopathy in type 1 diabetes. Arch Ophthalmol. 1984;102(4):520-526. https://doi.org/10.1001/archopht.1984.01040030398010
Wong TY, Klein R, Klein BE, Tielsch JM, Hubbard LD, Nieto FJ. Retinal microvascular abnormalities and their relationship with hypertension. N Engl J Med. 2004;351(8):710-720.
Miller RG, Anderson SJ, Costacou T, Sekikawa A, Orchard TJ. Lipids and the progression of diabetic retinopathy in type 1 diabetes: The Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care. 2013;36(9):2610-2617.
Keech AC, Mitchell P, Summanen PA, O'Day J, Davis TM, Moffitt MS, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): A randomised controlled trial. Lancet. 2007;370(9600):1687-1697. https://doi.org/10.1016/S0140-6736(07)61607-9
ACCORD Eye Study Group; Chew EY, Ambrosius WT, Davis MD, Danis RP, Gangaputra S, et al. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010;363(3):233-244. https://doi.org/10.1056/NEJMoa1001288
Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: A systematic review. JAMA. 2007;298(8):902-916. https://doi.org/10.1001/jama.298.8.902
Klein R, Klein BEK, Moss SE. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XV. The 15-year incidence and progression of diabetic retinopathy and associated risk factors. Ophthalmology. 1998;105(10):1801-1815. https://doi.org/10.1016/S0161-6420(98)91020-X
Kowluru RA, Chan PS. Oxidative stress and diabetic retinopathy. Exp Diabetes Res. 2007;2007:43603. https://doi.org/10.1155/2007/43603
Raman R, Rani PK, Reddi Rachepalle S, Gnanamoorthy P, Uthra S, Kumaramanickavel G, et al. Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS). Ophthalmology. 2009;116(2):311-318. https://doi.org/10.1016/j.ophtha.2008.09.010
Gadkari SS, Maskati QB, Nayak BK. Prevalence of diabetic retinopathy in India: The All India Ophthalmological Society diabetic retinopathy eye screening study 2014. Indian J Ophthalmol. 2016;64(1):38-44. https://doi.org/10.4103/0301-4738.178144
American Diabetes Association. Standards of Medical Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S1-S170.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sweta Bharti, Amit Kumar

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
















