Blood donor BP measurements may provide a useful complementary source of data for nationwide hypertension surveillance, yielding a high rate of screening positivity.
Key Findings
Results
The majority of blood donor visits screened positive for elevated BP or hypertension, with only 17.87% of observations showing normal BP.
Analysis included 20,849,150 donor visits from 6,192,654 donors across American Red Cross blood donor centers and mobile units nationwide from 2019 to 2025.
82.13% of observations screened positive for elevated BP (10.56%) or hypertension (71.57%).
Hypertension was categorized as stage 1 (34.57%) or stage 2 (37.00%).
Only donors aged ≥25 years were included.
BP categories were assigned using standard clinical guidelines.
Results
Elevated BP or hypertension was more common among donors aged ≥40 years, men, and those residing outside metropolitan areas.
Age threshold of ≥40 years was associated with higher rates of elevated BP and hypertension screening positivity.
Male sex was identified as a demographic factor associated with higher rates of elevated BP or hypertension.
Residing outside metropolitan areas was associated with higher rates of elevated BP or hypertension.
These subgroup differences were identified through retrospective analysis of routine BP measurements.
Results
The proportion of donors screening positive for stage 2 hypertension increased over time from 2019 to 2025, with a corresponding decline in normal BP.
The temporal trend spanned a six-year observation period from 2019 to 2025.
Stage 2 hypertension (systolic ≥140 mmHg or diastolic ≥90 mmHg by standard clinical guidelines) showed increasing prevalence across the study period.
The increase in stage 2 hypertension was accompanied by a corresponding decline in normal BP observations.
These trends were captured through routine BP screening conducted as part of standard blood donation eligibility procedures.
Conclusions
Blood donation centers represent a scalable, population-level platform for hypertension surveillance complementary to existing national data sources.
The study covered American Red Cross blood donor centers and mobile units across the United States.
Over 20 million donor visits and over 6 million unique donors were captured, representing a large nationwide sample.
BP screening is already conducted routinely as part of blood donation eligibility assessment, requiring no additional infrastructure.
The authors describe this as a 'scalable, population-level opportunity to enhance hypertension surveillance and prevention.'
What This Means
This research suggests that blood donation centers across the United States could serve as an important and largely untapped resource for tracking high blood pressure (hypertension) at a national scale. By analyzing over 20 million blood donation visits between 2019 and 2025, researchers found that more than 8 in 10 donor visits resulted in a blood pressure reading that was either elevated or in the hypertension range — a strikingly high proportion. Only about 18% of readings were in the normal range. Because blood pressure is already measured routinely before every donation, this data is collected without any extra cost or effort.
The study also found that high blood pressure readings were more common among donors who were 40 years old or older, male, or living outside of major cities. Perhaps most concerning, the proportion of donors with the most severe category — stage 2 hypertension — grew over the six-year study period, while normal blood pressure readings became less common. This trend mirrors broader public health concerns about rising hypertension rates in the United States.
This research suggests that the American Red Cross blood donation network, which operates centers and mobile units nationwide, could function as a complementary surveillance system to help public health officials better understand where and among whom hypertension is most prevalent. Since millions of people donate blood each year, this approach could capture data from populations that might not regularly visit a doctor, potentially identifying people with undiagnosed high blood pressure and informing targeted prevention efforts.
Young P, Singh U, Twiner M, Levy P. (2026). Blood Donation Encounters as a National, Publicly Available Platform for Hypertension Surveillance.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.049632