Racial Differences in the Relationship Between Blood Pressure and Risk of Retinopathy Among Individuals With NIDDM
- Emily L Harris, PHD, MPH,
- Susan Feldman, RN, MS,
- C Rahj Robinson, AA,
- Steven Sherman, MD and
- Angeljki Georgopoulos, MD
- Department of Epidemiology, School of Hygiene and Public Health; the Department of Medicine and the Department of Ophthalmology, the Wilmer Institute, School of Medicine, the Johns Hopkins University Baltimore Maryland; the Department of Medicine, University of Minnesota; and the Veteran's Administration Medical Center Minneapolis, Minnesota
- Address correspondence and reprint requests to Emily L. Harris, PHD, MPH, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205.
Abstract
OBJECTIVE To assess whether the prevalence of retinopathy differs between blacks and whites with diabetes and to examine differences between blacks and whites in the relationship between risk factors for and prevalence of retinopathy. Population data suggest diabetic retinopathy is either more prevalent or more severe in blacks than in whites.
RESEARCH DESIGN AND METHODS We analyzed data from a screening study for retinopathy among patients with diabetes, conducted in Maryland from 1986–1990.
RESULTS After adjusting for age, duration of diabetes, type of treatment for diabetes, and presence or absence of high blood pressure, black men with NIDDM were ∼23% more likely to have retinopathy than other race-sex groups (not statistically significant). We also found a different relationship between systolic blood pressure and retinopathy prevalence in blacks than in whites among individuals with NIDDM. Among blacks, the risk increased as systolic blood pressure increased, even within the normal range, and reached statistical significance at > 150 mmHg. Among whites, the risk was increased only among those with high systolic blood pressure (>140 mmHg) and did not reach statistical significance.
CONCLUSIONS Our data are consistent with the hypothesis that differences exist between blacks and whites in risk of diabetic retinopathy, and that the effect of blood pressure on risk of retinopathy differs between blacks and whites.
- Received December 4, 1991.
- Revision received January 7, 1993.
- Accepted January 7, 1993.
- Copyright © 1993 by the American Diabetes Association
