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Screening for High Blood Pressure in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement FREE

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The full report is titled “Screening for Primary Hypertension in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 5 November 2013 issue of Annals of Internal Medicine (volume 159, pages 613-619). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published online first at www.annals.org on 7 October 2013.

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Ann Intern Med. 2013;159(9):I-30. doi:10.7326/0003-4819-159-9-201311050-00723
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

High blood pressure (hypertension) is common in adults. Hypertension strains the heart and harms blood vessels. It increases the risk for complications, such as heart problems, stroke, kidney problems, and eye problems. Diet, exercise, and medication can decrease blood pressure and the chances of having these complications.

People with hypertension usually do not have symptoms, so they typically do not know that they have it until someone measures their blood pressure or detects a possible complication. Screening for high blood pressure involves routinely measuring blood pressure in people who seem to be well. Normal blood pressure is lower than 140 mm Hg systolic (the first number, which is measured when the heart is pumping) and 90 mm Hg diastolic (the second number, which is measured when the heart is relaxing).

Although hypertension is very common in adults, approximately 1 to 5 out of every 100 children and adolescents also have hypertension. The strongest risk factor for hypertension in children and adolescents is being overweight. Finding and treating hypertension early in young people could lower their risk for complications during adulthood. To help clinicians decide whether to screen, it is necessary to know whether early detection actually improves health outcomes. It is also important to consider the potential harms of starting blood pressure medications and other treatments in young people.

Health care organizations, including the USPSTF, recommend screening for hypertension in adults. In 2003, the USPSTF could not make a recommendation about screening for hypertension in children and adolescents because not enough was known to balance the benefits and harms of screening.

How did the USPSTF develop these recommendations?

The USPSTF reviewed the research published since its 2003 recommendation to see whether there was now enough information to make a definite recommendation about whether to screen for hypertension in children and adolescents.

What did the authors find?

The USPSTF found that good information was still lacking about the accuracy of blood pressure screening in children and adolescents, whether screening accurately identifies children and adolescents at high risk for heart disease and other complications of hypertension, and the benefits and harms of treating hypertension in children and adolescents.

What does the USPSTF recommend that patients and doctors do?

The USPSTF concluded that there is not enough information to weigh the balance of benefits and harms of screening for hypertension in all children and adolescents. Until further information becomes available, the doctor and patient should make a decision to screen on the basis of the patient's specific situation, such as whether the child is overweight.

What are the cautions related to these recommendations?

These recommendations apply only to children and adolescents who do not have signs or symptoms of hypertension. If such signs and symptoms are present, blood pressure should be measured.





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