People with diabetes already know they need regular check-ups to protect their health. They often visit doctors to monitor their blood sugar, kidneys, feet, and eyes.
However, a new study suggests that one simple test performed during an eye examination could save lives. Researchers from the University of Virginia School of Medicine found that many people with diabetes have dangerously high blood pressure without realizing it. Their findings were published in JAMA Ophthalmology.
High blood pressure and diabetes are a dangerous combination. Diabetes can damage blood vessels throughout the body, while high blood pressure places even more stress on those vessels. Together, they greatly increase the risk of heart attacks, strokes, kidney disease, vision loss, and other serious complications.
One of the organs most affected is the eye. Diabetes can cause diabetic retinopathy, a disease that damages the tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye.
High blood pressure makes this damage worse and can also contribute to swelling in the center of the retina, known as diabetic macular edema, leading to blurred vision or even blindness.
To see how common high blood pressure was among eye clinic patients, the researchers studied 172 adults with type 1 or type 2 diabetes. Before their eyes were dilated, clinic staff measured each person’s blood pressure.
Participants also answered questions about whether they had high blood pressure, whether they thought it was well controlled, how often they checked it at home, and whether they believed blood pressure affected eyesight.
The results were alarming. Only about 8% of participants had normal blood pressure. About half already had stage 2 hypertension, and around one in ten had blood pressure high enough to be considered a hypertensive crisis, a medical emergency that can quickly lead to a heart attack or stroke if left untreated.
The study also showed that many people misunderstood their own health. Among participants who had never been told they had high blood pressure, most actually had abnormal readings, and more than one-third already had stage 2 hypertension.
Even among people who believed their blood pressure was under good control, more than half still had stage 2 hypertension, while some had readings high enough to require urgent medical attention.
The blood pressure checks made an immediate difference. Nearly 60% of patients were advised to contact their family doctor, some needed rapid follow-up within one or two days, and one person was sent directly to the emergency department.
Patients strongly supported the idea of having their blood pressure checked during eye appointments. More than 90% felt it was reasonable, and many appreciated learning about health problems they did not know they had.
This study was relatively small and came from a single medical center, so larger studies are needed. However, the findings are clinically important because they revealed a major gap between what patients believed and their actual blood pressure.
Adding routine blood pressure checks to diabetic eye clinics is inexpensive, simple, and could identify many people who need urgent treatment before serious complications develop.
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Source: University of Virginia School of Medicine.
