Tight BP control protects diabetic eye

Dr Jitendra Singh
Diabetes is an absolutely preventable cause of blindness and yet, quite ironically, one of the commonest causes of blindness. High Blood Sugar and high Blood Pressure together constitute a double assault and therefore tight Blood Pressure control may help reduce risk of diabetic effect on eye.
The primary focus of Diabetes management in 21st century is the protection of target organs like heart, kidney and eyes. While strict control of Blood Sugar is the basic prerequisite for the success of any preventive strategy, the importance of simultaneous aggressive treatment of co-morbidities or co-afflictions like hypertension or high blood pressure is being increasingly realised.
Diabetes is an absolutely preventable cause of blindness and yet, quite ironically, one of the commonest causes of blindness. High Blood Sugar and high Blood Pressure together constitute a double assault and therefore tight Blood Pressure control may help reduce risk of diabetic effect on eye.
LOWER BLOOD PRESSURE TARGETS
That the hypertension or high blood pressure increases the risk for development of microvascular disease affecting various organs including the eye has been well documented over the years by a number of widely published studies from authentic sources. There is also enough evidence to suggest that both the prevalence and severity of diabetic effect on eye is markedly reduced by interventions aimed at lowering the blood pressure. In a recent study, the investigations have further sought to substantiate this by using four-field retinal photography to evaluate the outcome of retinopathy through tight Bp control strategy.
The target levels of Blood Pressure recommended for a Diabetic are much lower than those in case of a non-Diabetic. This means that in case of a Diabetic, the lower the Blood Pressure the better it may be for the overall long-term outcomes. In other words, if, for example, the treatment of  hypertension in a non-Diabetic aims at bringing down the levels below 140/90 or 135/85 mm Hg, in case of a Diabetic the aim should be to bring down the levels to the range of 130/80 mm Hg. A treatment strategy that targets a blood pressure level of 120/80 mm Hg will further reduce the incidence and progession of diabetic retinopathy of the eye.
EARLY ANTIHYPERTENSIVE TREATMENT RECOMMENDED
High Blood Pressure is detrimental to each aspect of diabetic retinopathy and therefore a tight BP control policy  helps reduce the risk of clinical complications in diabetic eye disease. Antihypertensive treatment beginning early in the course of Type 2 Diabetes Mellitus is supported by a number of documented reports including the worldwide acknowledged UKPDS data.
Hypertension or high BP in the presence of Diabetes constitutes a double assault on  target organs including the eye. Tight control of blood pressure right form the beginning is recommended preferably using drugs which also have additional preventive effect against complications.
It is finally the responsibility of the medical professionals, particularly Diabetologists and Opthalmologists, to educate the diabetes affected individuals under their care about the benefits of Blood Pressure control

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