Blood Donation Encounters as a National, Publicly Available Platform for Hypertension Surveillance.

BACKGROUND: To evaluate the usefulness of blood pressure (BP) screening during blood donation as a nationwide network for hypertension surveillance. METHODS: We conducted a retrospective analysis of routine BP measurements collected at American Red Cross blood donor centers and mobile units across the United States from 2019 to 2025. Volunteer blood donors aged ≥25 years were included. BP categories (normal, elevated, stage 1 hypertension, stage 2 hypertension) were assigned using standard clinical guidelines. RESULTS: We analyzed 20 849 150 donor visits from 6 192 654 donors. Overall, 17.87% of observations had normal BP, whereas 82.13% screened positive for elevated BP (10.56%) or hypertension (71.57%; 34.57% stage 1, 37.00% stage 2). Elevated BP or hypertension was more common among donors aged ≥40 years, men, and those residing outside metropolitan areas. The proportion who screened positive for stage 2 hypertension increased over time, with a corresponding decline in normal BP. CONCLUSIONS: Blood donor BP measurements may provide a useful complementary source of data for nationwide hypertension surveillance, yielding a high rate of screening positivity. Blood donation settings offer a scalable, population-level opportunity to enhance hypertension surveillance and prevention.