Oct 07, 2013
The US Preventive Services Task Force (USPSTF) has concluded that "the current evidence is insufficient to assess the balance of benefits and harms of screening for primary hypertension in asymptomatic children and adolescents to prevent subsequent cardiovascular disease in childhood or adulthood."
The recommendation stands in contrast to the endorsement from the American Academy of Pediatrics of the National High Blood Pressure Education Program 2004 recommendations that children aged 3 years or older have their blood pressure measured at least once at every "health care episode."
The USPSTF published their recommendation statement online October 7 in both the Annals of Internal Medicine andPediatrics . Task force members reviewed studies published since 2003 and could not find any clear evidence that justified blood pressure screening in the general pediatric population.
The recommendations, which are an update to 2003 recommendations, relate specifically to children and teenagers who do not have an underlying health problem and have no signs or symptoms of high blood pressure and encourage clinicians to consider each patient specifically and make an individual decision for each patient.
As the childhood obesity rate has increased, so has the prevalence of high blood pressure in children and teenagers. The prevalence of hypertension among US children and adolescents ranges from 1% to 5%. The prevalence of hypertension among obese children is 11%.
Some clinicians have proposed that screening for hypertension in children and adolescents may allow for interventions to reduce blood pressure, thereby reducing the risk for cardiovascular events and death in adulthood. However, the task force could not find evidence to substantiate this hypothesis.
"We call on the research community to strengthen the evidence base linking screening and treatment of high blood pressure in children and teens to their long-term cardiovascular health," said USPSTF member Kirsten Bibbins-Domingo, MD, PhD, in a USPSTF news release.
Full conflict-of-interest information is available on the journal's Web sites.
Pediatrics. Published online October 7, 2013. Abstract
Ann Intern Med. Published online October 7, 2013. Full tex
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