Could Intensive Blood Pressure Control Really Reduce Diabetic Retinopathy Outcomes? Evidence from Meta-Analysis and Trial Sequential Analysis from Randomized Controlled Trials

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
Jian-Bo ZhouJin-Kui Yang

Abstract

To explore the accumulated evidence concerning the effect of intensive blood pressure control on the incidence and progression of diabetic retinopathy (DR), proliferative diabetic retinopathy (PDR) and macular edema (ME). A number of electronic databases were searched including PubMed, EMBASE, CINAHL, Cochrane Library, conferences and proceedings. Randomized controlled trials comparing intensive blood pressure targets with conventional blood pressure targets in patients with type 2 diabetes were included. The definition of intensive versus conventional blood pressure targets was from the pertinent original studies. Meta-analyses and trial sequential analyses of randomized trials were analyzed in STATA. Eight trials randomizing 6989 patients were assessed and reviewed in full text; 3749 vs. 3240 were in each arm (intensive vs. conventional). All trials had a low risk of bias. Intensive blood pressure control supported a 17% reduction in the incidence of DR (relative risk 0.83, 95% confidence interval 0.72-0.95). Trial sequential analyses confirmed that sufficient evidence indicated a relative risk reduction above 17% for the incidence of DR when intensive blood pressure control was targeted. Heterogeneity was absent (I2 = 0%; P ...Continue Reading

References

Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Oct 31, 1997·Lancet·G Davey Smith, M Egger
Jan 31, 2003·The New England Journal of Medicine·Peter GaedeOluf Pedersen
May 6, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Jul 1, 2010·The New England Journal of Medicine·UNKNOWN ACCORD Study GroupLawrence J Fine
Jan 18, 2011·International Journal of Clinical Practice·A K SjølieF R R Hobbs
Aug 31, 2014·Ophthalmology·Emily Y ChewUNKNOWN Action to Control Cardiovascular Risk in Diabetes Eye Study Research Group
Sep 23, 2014·The New England Journal of Medicine·Sophia ZoungasUNKNOWN ADVANCE-ON Collaborative Group
Feb 11, 2015·The Lancet. Diabetes & Endocrinology·Bin WangYan-Gang Wang
May 11, 2016·Statistics in Medicine·Alessio CrippaDonna Spiegelman
Jun 12, 2016·Diabetes Care·UNKNOWN Action to Control Cardiovascular Risk in Diabetes Follow-On (ACCORDION) Eye Study Group and the Action to Control Cardiovasc
Jun 30, 2016·Ophthalmic Epidemiology·Charumathi SabanayagamTien Y Wong
Dec 19, 2016·Clinical & Experimental Ophthalmology·Samantha Fraser-BellAnagha Vaze

❮ Previous
Next ❯

Citations

Apr 12, 2019·Journal of the American Heart Association·Masahiko YamamotoHirohito Sone
Sep 25, 2019·The Journal of International Medical Research·Jian-Bo ZhouJin-Kui Yang
May 1, 2021·International Journal of Molecular Sciences·Enrique Antonio Alfonso-MuñozCarmen Desco
Jan 31, 2022·Diabetic Medicine : a Journal of the British Diabetic Association·Mike TrottShahina Pardhan

❮ Previous
Next ❯

Software Mentioned

ADVANCE
Cochrane Handbook risk
TSA
ACCORDION eye
STATA
DIRECT Protect2
ACCORD eye

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.