Screening for Primary Hypertension in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement*

  title={Screening for Primary Hypertension in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement*},
  author={Virginia A. Moyer},
  journal={Annals of Internal Medicine},
  pages={613 - 619}
  • V. Moyer
  • Published 5 November 2013
  • Medicine
  • Annals of Internal Medicine
DESCRIPTION Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for high blood pressure in children and adolescents. METHODS The USPSTF reviewed the evidence on screening and diagnostic accuracy of screening tests for blood pressure in children and adolescents, the effectiveness and harms of treatment of screen-detected primary childhood hypertension, and the association of hypertension with markers of cardiovascular disease in childhood and adulthood… 

Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger.

Controversy about hypertension screening in children: a clinical perspective.

The authors of the review fail to acknowledge that measurement of blood pressure, a cheap integral part of any careful physical examination, is too infrequently recorded in everyday pediatric practice, and the recommendation statement seems to ignore the fact that in many countries all newborn infants undergo routine metabolic blood screening for inherited disorders that are by far more rare than arterial hypertension.

Controversy about hypertension screening in children: a public health perspective.

Observations support the view that screening and treatment of hypertension should begin from childhood, and why there are doubts about its potential benefits and harms and propose avenues to solve the controversy.

The USPSTF call to inaction on blood pressure screening in children and adolescents

The USPSTF statement is based on insufficient evidence that BP screening in childhood decreases cardiovascular disease (CVD) in adulthood, and prospective cohort studies that include BP measurements from childhood to early adulthood provide insights on a life-course connection of higher BP levels in childhood with intermediate markers of CVD in early adulthood.

Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement.

A systematic review concluded with high certainty that screening for hypertension in adults has substantial net benefit and recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment.

An Alternative View of Childhood Blood Pressure Screening: Reframing the Question.

The United States Preventive Services Task Force (USPSTF) has issued an I statement (insufficient evidence) regarding the benefits and harms of childhood blood pressure (BP) screening.1,2 This

Screening for cardiovascular disease risk factors beginning in childhood

It is suggested that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormalBlood glucose, or smoking in children and adolescents and efforts should rather focus on the primordial prevention of CVD risk factors.

Screening for Hypertension in Children and Adolescents: Methodology and Current Practice Recommendations

Key issues contributing to the inaccurate measurement of blood pressure and misclassification of HTN among children are explicated and strategies to address these issues are presented.

Response to “U.S. Preventive Services Task Force Recommendation and Pediatric Hypertension Screening: Dereliction of Duty or Call to Arms?”

The U.S. Preventive Services Task Force (USPSTF) has concluded that “current evidence is insufficient to assess the balance of benefits and harms” of screening for high BP in asymptomatic children to prevent heart disease and should not be measured routinely in otherwise healthy children and adolescents.

Hypertension screening in children: is it necessary?

The possible opportunity to perform screening for primary hypertension in children and adolescents should be taken into consideration for those countries that do not have a system of primary paediatric care and the use of the term ‘screening’ is not quite appropriate.



Screening for Hypertension in Children and Adolescents to Prevent Cardiovascular Disease

There is no direct evidence that screening for hypertension in children and adolescents reduces adverse cardiovascular outcomes in adults, and additional studies are needed to improve diagnosis and risk stratification of children with elevated blood pressure.

Screening for high blood pressure: recommendations and rationale.

Hypertension in children and adolescents.

Recommendations for pharmacologic treatment are based on symptomatic hypertension, evidence of end-organ damage, stage 2 hypertension, stage 1 hypertension unresponsive to lifestyle modifications, and hypertension with diabetes mellitus.

Hypertension Screening During Ambulatory Pediatric Visits in the United States, 2000–2009

Estimating the frequency of hypertension screening during ambulatory pediatric visits in the United States and identifying patient- and provider-level factors associated with screening during visits specifically for preventive care found that providers do not measure blood pressure in two-thirds of pediatric visits and one-third of pediatric preventive visits.

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report

This report summarizes the findings of the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk and outlines its recommendations for further study.

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents

  • Medicine
  • 2004
This survey highlights the need to understand more fully the rationale behind the continued use of these devices, as well as their applications, in patients with high blood pressure.

Performing Preventive Services: A Bright Futures Handbook

This manual provides authoritative, evidence-based guidance about the most effective ways to deliver preventive services and serves as a teaching tool for medical students, residents, and all health professionals who provide well child care.

Recommendations for Blood Pressure Measurement in Humans: An AHA Scientific Statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee

This document represents a major revision of previous versions of the American Heart Association blood pressure measurement recommendations, during which time there have been major changes in the ways in which BP is measured in clinical practice and research.

Clinical and Demographic Characteristics of Children With Hypertension

It is concluded that hypertensive children <6 years are more likely to have secondary hypertension and to have higher diastolic blood pressure and lower glomerular filtration rate and are less likely to be obese or to have elevated cholesterol than school-aged children or adolescents.

Diagnosis of secondary hypertension: an age-based approach.

All children with confirmed hypertension should have an evaluation for an underlying etiology that includes renal ultrasonography, and the recommended initial diagnostic test is an aldosterone/ renin ratio.