Q&A

Tight blood pressure control prevents blindness in patients with diabetes

J Fam Pract. 2005 February;54(2):105-113
Author and Disclosure Information

  • CLINICAL QUESTION: Does tight blood pressure control improve visual outcomes in diabetic hypertensive patients?
  • STUDY DESIGN: Randomized controlled trial (double-blinded)
  • ALLOCATION: Concealed
  • SETTING: Outpatient (any)
  • SYNOPSIS: This is yet another report from the landmark United Kingdom Prospective Diabetes Study (UKPDS) of patients with type 2 diabetes. In this substudy, 1148 hypertensive patients with diabetes were randomly assigned in a 2:1 ratio to tight or loose control of blood pressure, with target blood pressures of 150/85 mm Hg or 200/105 mm Hg, respectively. The loose control target was changed to 185/105 mm Hg midway through the study.
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BOTTOM LINE

Tight blood pressure control results in a small benefit in the prevention of blindness, with a number needed to treat of 1000 per year. Tight control was also associated with a reduction in loss of visual acuity after 9 years (but not with shorter durations of follow-up) and an increase in the likelihood of cataract extraction. (LOE=1b)

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