Association of Blood Pressure With Intraocular Pressure and Glaucoma in the General Adult Population – Opportunistic Screening in the “Hunting the Silent Killer” Action

Objective: Blood pressure (BP) has been found to be positively associated with intraocular pressure (IOP), although a J-curve association of BP with primary open-angle glaucoma has also been observed. We aimed to analyze the association between BP and IOP in a general adult population through an opportunistic screening study. Design and method: This cross-sectional study was conducted in August 2025 on the island of Dugi Otok, Croatia, as a part of the public health action “Hunting the silent killer” organized by the Croatian Hypertension League. A total of 269 adult participants were recruited through voluntary, opportunistic sampling (average age of 65; 56.9% women). BP was measured using the Microlife BP B3 AFIB according to guideline recommendations, and IOP was measured using the iCare® IC200 tonometer. Participants were divided into a diagnosed glaucoma, group A (N = 21) and a non-glaucoma group B (N = 248). Results: Medians of BP and IOP in the whole group were 141/82 mmHg (IQR 129–155/75–89) and 17/19 mmHg (IQR 14–20/17–21), respectively. Weak positive associations were observed between BP and IOP (systolic BP: right eye r = 0.20, p = 0.004, 95% CI [0.066, 0.332]; left eye r = 0.18, p = 0.011, 95% CI [0.043, 0.311]; diastolic BP: right eye r = 0.20, p =0.004, 95% CI [0.066, 0.332]; left eye r = 0.18, p = 0.011, 95% CI [0.043, 0.311]). A significant difference in systolic BP between group A and group B was observed (157 mmHg [IQR 135–167] vs. 140 mmHg [IQR 129–153]; p = 0.034), whereas no significant difference was observed for diastolic BP (81 mmHg [IQR 75–88] vs. 82 mmHg [IQR 75–90]; p = 0.936). Conclusions: Weak but statistically significant positive correlations were observed between BP and IOP. Systolic BP was higher in patients diagnosed with glaucoma. These results and high prevalence of glaucoma (7.8%) suggests that measurements of IOP might be valuable if included in the opportunistic screening studies.