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The role of blood pressure stability in diabetic retinopathy development

Chin-Chih Shih1, Ling-Na Shih2, Hung-An Lin2

  • 1Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Eye (London, England)
|December 2, 2025
PubMed

Insights

Extreme blood pressure levels and high blood pressure variability increase diabetic retinopathy risk. Maintaining stable blood pressure is key for prevention.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Endocrinology

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss in diabetic patients.
  • The relationship between blood pressure (BP) and DR, including BP variability, requires further investigation.

Purpose of the Study:

  • To investigate the non-linear association between BP and DR.
  • To determine the impact of BP variability on DR development in type 2 diabetes patients.

Main Methods:

  • Retrospective longitudinal cohort study of 969 type 2 diabetes patients without DR at baseline.
  • BP measurements and DR assessments were conducted over a mean follow-up of 4.96 years.
  • Logistic regression analysis was used to assess the association between BP parameters (mean and variability) and DR incidence.

Main Results:

  • A U-curve/J-curve association was observed between mean systolic BP, diastolic BP, mean arterial pressure, and pulse pressure and DR risk.
  • Optimal BP ranges for lowest DR risk were identified: SBP 130-135 mmHg, DBP 75-80 mmHg, MAP 95-100 mmHg, PP 50-55 mmHg.
  • Increased visit-to-visit BP variability (SD of SBP, DBP, MAP, PP) was independently associated with a higher risk of DR development.

Conclusions:

  • Both extreme BP levels and greater BP variability are risk factors for DR.
  • Maintaining stable and optimal BP levels may be crucial in preventing DR development.
Abstract

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