Ophthalmology Clinics Can Help Detect Uncontrolled Hypertension in Adults with Diabetes: Study
Researchers have found in a prospective case series that more than half of adults with diabetes attending an ophthalmology clinic had previously unrecognized or inadequately controlled hypertension, despite most believing their blood pressure was well controlled. These findings highlight the value of incorporating blood pressure screening into ophthalmology visits, providing an important opportunity to identify uncontrolled hypertension early and improve cardiovascular risk management in patients with diabetes. The study was published in JAMA Ophthalmology by Sai S. and colleagues.
The medical team recruited adults aged 18 years and above, with documented cases of either type 1 or type 2 diabetes seeking retinal care. Each patient received immediate BP testing in the clinic and had to fill out a structured questionnaire concerning their individual history of hypertension, use of home monitoring devices, perception of disease management, and basic knowledge about the heart condition. Normal BP was defined according to the 2017 American College of Cardiology/American Heart Association guidelines that rely on both systolic and diastolic readings.
According to these guidelines, BP was considered normal when systolic was less than 120 mm Hg and diastolic less than 80 mm Hg; elevated BP was defined as 120 to 129 mm Hg over less than 80 mm Hg; stage 1 hypertension included the range from 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic; stage 2 hypertension was determined by 140 mm Hg or higher systolic or 90 mm Hg diastolic or higher; and hypertensive crisis – by 180 mm Hg systolic and/or 120 mm Hg diastolic or higher.
Key findings:
- The prospective study proved to be efficient in terms of monitoring and obtaining data on a total sample of 172 adult patients having diabetes.
- The screened sample of patients had the mean age equal to 66.6±13.9 years, with precisely 84 female patients, accounting for 48.8% of all subjects included in the sample.
- From the 172 patients included in the total sample, as many as 91 patients (52.9%) were characterized by stage 2 hypertension, and another 18 subjects (10.5%) experienced active, asymptomatic hypertensive crisis.
- Medical diagnosis of hypertension was reported in 144 out of 172 patients (83.7%), with 131 out of 144 (91.0%) being under antihypertensive treatment.
- Even though 100 out of 144 patients with hypertension (69.4%) perceived their condition as being under control or being optimal, 115 of 144 patients (79.9%) had blood pressure at the level of stage 1 hypertension or higher.
- Out of 28 patients without any medical history of high blood pressure, 24 people (85.7%) had elevated blood pressure, with 10 (35.7%) of them suffering from stage 2 hypertension, and 3 (10.7%) experiencing an active hypertensive crisis.
- Following their eye appointments, 103 out of the 172 total patients (59.9%) were formally advised to immediately contact their primary care physician, and 20 individuals (11.6%) required emergency, expedited follow-up care due to dangerously high readings.
Conclusively, in this case series study in a single center, the high prevalence of uncontrolled or undiagnosed hypertension in patients with diabetes is evident. The opportunistic screening of BP in ophthalmology clinics is possible and can identify significant risk factors of heart disease. This very interesting and convincing clinical evidence provides a very important empirical basis for integrated medicine. Saving a patient's vision involves much more than merely examining the eyes.
Reference:
Samayamanthula S, Williams J, Markowski A, et al. Blood Pressure Assessment in Ophthalmology Clinics for Patients With Diabetes. JAMA Ophthalmol. Published online June 25, 2026. doi:10.1001/jamaophthalmol.2026.2245
