TOPLINE

A substantial proportion of adults with diabetes who visited retina clinics had uncontrolled or previously unrecognized high blood pressure (BP) and were often advised to seek follow-up medical care; many of them were already on antihypertensive treatment.

METHODOLOGY

• Researchers conducted a prospective case series to assess the prevalence of elevated or uncontrolled BP in adults with diabetes during routine visits to retina clinics.
• They enrolled 172 adults with type 1 or type 2 diabetes (mean age, 66.6 years; 48.8% women) at a US retina clinic between July and August 2024. Of the group, 144 had a prior diagnosis of hypertension.
• Based on BP readings, patients were classified as having normal BP (< 120/< 80 mm Hg), elevated BP (120-129/< 80 mm Hg), stage 1 hypertension (130-139 mm Hg systolic or 80-89 mm Hg diastolic), stage 2 hypertension (140-180 mm Hg systolic or ≥ 90 mm Hg diastolic), or hypertensive crisis (> 180 mm Hg systolic and/or > 120 mm Hg diastolic).
• Researchers collected survey data on measures such as habits of home monitoring, the use of antihypertensives, and patient understanding of the link between high BP and eye health and reviewed immediate management steps.

TAKEAWAY

• At the clinic visit, 8.1% had normal BP, 13.4% had elevated BP, 15.1% had stage 1 hypertension, 52.9% had stage 2 hypertension, and 10.5% met the criteria for hypertensive crisis.
• Among adults with known hypertension, 79.9% had BP of at least 130/80 mm Hg and 66.0% had stage 2 hypertension or hypertensive crisis despite 91.0% being on antihypertensive medications. Among those without prior hypertension, 85.7% had an above-normal reading.
• Clinic staff advised 59.9% of adults to contact their primary care clinician, arranged expedited follow-up for 11.6%, and directed 0.6% to the emergency department.
• Most patients (97.7%) had checked BP within the past year, 72.1% had a home BP monitor, and 74.4% understood that high BP could affect their eye health.

IN PRACTICE

“Retina clinics are among the busiest outpatient environments in medicine, with growing patient volumes, expanding imaging requirements, and increasing therapeutic complexity. Any proposal to incorporate routine systemic screening must therefore balance feasibility, staffing, clinic efficiency, documentation burden, medicolegal responsibility, and downstream referral pathways,” Rishi P. Singh, MD, wrote in an invited commentary accompanying the journal article.

SOURCE

The study was led by Sai Samayamanthula, of the University of Virginia School of Medicine in Charlottesville, Virginia. It was published online on June 25 in JAMA Ophthalmology.

LIMITATIONS

The study was conducted at a single center and had a limited enrollment window of 6 weeks. BP was measured only once per visit, and single readings may not confirm a diagnosis of hypertension. All participants came from a retina referral clinic with many advanced cases, thus limiting generalizability to other eye clinics.

DISCLOSURES

The authors did not report any source of funding or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.