More research needed on screening children and adolescents for high blood pressure
The U.S. Preventive Services Task Force concluded that more research is needed to make a recommendation about screening for high blood pressure in children and adolescents, according to a press release from the Agency for Healthcare Research and Quality.
The task force’s final recommendation statement was published November 10, 2020, online at JAMA and the task force’s website.
The prevalence of hypertension (both primary and secondary) in children and adolescents in the United States ranges from 3 percent to 4 percent. Primary hypertension in children and adolescents occurs primarily in children older than 13 years and is associated with risk factors such as family history and body mass index. Secondary hypertension occurs primarily in younger children and is most commonly caused by genetic disorders, renal disease, endocrine disorders, or cardiovascular abnormalities.
Among the research gaps the task force noted are the following:
· The accuracy of blood pressure measurements with sphygmomanometers or oscillometric automated devices and establishing thresholds for hypertension for 24-hour ambulatory monitoring.
· The application of new thresholds for determining abnormal blood pressure to existing data sets and testing the validity of these thresholds.
· The benefits and harms of long-term pharmacologic treatment.
· The benefits and harms of screening.
· The long-term natural history of hypertension in children and the spontaneous resolution of hypertension.
· The associations among childhood hypertension, adulthood hypertension, and surrogate measures of cardiovascular disease in childhood and adulthood, as well as adulthood clinical cardiovascular disease.
· The harms of medications, long-term adherence with treatment, and the effect of individual components of multifactorial interventions.