Blood Pressure Screening in Retina Clinics for Patients With Diabetes

Key Takeaways

• Stage 2 hypertension was the most common blood pressure category in this retina-clinic diabetes cohort, and hypertensive crisis readings were also observed.
• Among patients with known hypertension, self-rated control often appeared more favorable than measured blood pressure during the clinic visit.
• More than half were advised to contact primary care, a smaller group needed expedited follow-up, and investigators reported screening appeared feasible and may identify actionable cardiovascular risk.

During retina visits, investigators obtained in-clinic blood pressure measurements and classified each result in the JAMA Ophthalmology study using 2017 ACC/AHA categories. Hypertensive crisis values were also recorded, and above-normal readings were seen among some patients without a previous hypertension diagnosis. Most participants already had a hypertension diagnosis, yet abnormal measurements remained frequent during the ophthalmology encounter. Overall, the clinic population showed a substantial burden of uncontrolled or previously unrecognized hypertension.

Data collection ran from July 2024 to August 2024 and included 172 adults aged 18 years or older with diabetes who presented to one academic retina clinic. The cohort had a mean age of 66.6 years, 84 patients were female, and additional clinical and ophthalmic information came from electronic medical records. Each patient underwent blood pressure measurement and completed a structured survey covering hypertension history, home monitoring, perceived control, and knowledge. Categories followed ACC/AHA thresholds, with normal blood pressure below 120/80 mm Hg, elevated blood pressure at 120 to 129 systolic with diastolic below 80, and higher stages defined by rising systolic or diastolic values. Data were analyzed from October 2025 to December 2025.

Across the cohort, 14 of 172 patients (8.1%) had normal blood pressure, while 91 of 172 (52.9%) had stage 2 hypertension and 18 of 172 (10.5%) met criteria for hypertensive crisis. A prior hypertension diagnosis was present in 144 of 172 patients (83.7%), and 131 of 144 (91.0%) were receiving antihypertensive therapy. Among 28 patients without known hypertension, 24 of 28 (85.7%) had above-normal readings, including 10 of 28 (35.7%) with stage 2 hypertension and 3 of 28 (10.7%) in hypertensive crisis by 2017 ACC/AHA criteria. Among patients with diagnosed hypertension, 100 of 144 (69.4%) rated control as good or excellent, yet 115 of 144 (79.9%) had stage 1 hypertension or greater. Measured readings often differed from patient awareness or prior diagnostic status.

Following measurement, 103 of 172 patients (59.9%) were advised to contact their primary care clinician, and 20 of 172 (11.6%) required expedited follow-up. These actions reflected abnormal readings identified during a routine ophthalmology encounter rather than outcomes after referral. The authors concluded that uncontrolled or previously unrecognized hypertension was highly prevalent in this setting, and they described opportunistic screening in ophthalmology clinics as feasible and potentially able to identify actionable cardiovascular risk. The study documented immediate follow-up recommendations after abnormal in-clinic readings were identified.