Alex H Krist1,2, Karina W Davidson3, Carol M Mangione4, Michael J Barry5, Michael Cabana6, Aaron B Caughey7, Katrina Donahue8, Chyke A Doubeni9, John W Epling10, Martha Kubik11, Gbenga Ogedegbe12, Lori Pbert13, Michael Silverstein14, Melissa A Simon15, Chien-Wen Tseng16,17, John B Wong18. 1. Fairfax Family Practice Residency, Fairfax, Virginia. 2. Virginia Commonwealth University, Richmond. 3. Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York. 4. University of California, Los Angeles. 5. Harvard Medical School, Boston, Massachusetts. 6. University of California, San Francisco. 7. Oregon Health & Science University, Portland. 8. University of North Carolina at Chapel Hill. 9. Mayo Clinic, Rochester, Minnesota. 10. Virginia Tech Carilion School of Medicine, Roanoke. 11. George Mason University, Fairfax, Virginia. 12. New York University, New York, New York. 13. University of Massachusetts Medical School, Worcester. 14. Boston University, Boston, Massachusetts. 15. Northwestern University, Evanston, Illinois. 16. University of Hawaii, Honolulu. 17. Pacific Health Research and Education Institute, Honolulu, Hawaii. 18. Tufts University School of Medicine, Boston, Massachusetts.
Abstract
IMPORTANCE: Prevalence of hypertension (both primary and secondary) in children and adolescents in the US ranges from 3% to 4%. Primary hypertension in children and adolescents occurs primarily in children older than 13 years and has no known cause but is associated with several risk factors, including family history and higher 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. OBJECTIVE: To update its 2013 recommendation, the USPSTF commissioned a review of the evidence on the benefits and harms of screening, test accuracy, the effectiveness and harms of treatment, and the association between hypertension and markers of cardiovascular disease in childhood and adulthood. POPULATION: This recommendation statement applies to children and adolescents aged 3 to 18 years not known to have hypertension or who are asymptomatic. EVIDENCE ASSESSMENT: The USPSTF concludes that the evidence to support screening for high blood pressure in children and adolescents is insufficient and that the balance of benefits and harms cannot be determined. RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for high blood pressure in children and adolescents. (I statement).
IMPORTANCE: Prevalence of hypertension (both primary and secondary) in children and adolescents in the US ranges from 3% to 4%. Primary hypertension in children and adolescents occurs primarily in children older than 13 years and has no known cause but is associated with several risk factors, including family history and higher 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. OBJECTIVE: To update its 2013 recommendation, the USPSTF commissioned a review of the evidence on the benefits and harms of screening, test accuracy, the effectiveness and harms of treatment, and the association between hypertension and markers of cardiovascular disease in childhood and adulthood. POPULATION: This recommendation statement applies to children and adolescents aged 3 to 18 years not known to have hypertension or who are asymptomatic. EVIDENCE ASSESSMENT: The USPSTF concludes that the evidence to support screening for high blood pressure in children and adolescents is insufficient and that the balance of benefits and harms cannot be determined. RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for high blood pressure in children and adolescents. (I statement).
Authors: David R Jacobs; Jessica G Woo; Alan R Sinaiko; Stephen R Daniels; Johanna Ikonen; Markus Juonala; Noora Kartiosuo; Terho Lehtimäki; Costan G Magnussen; Jorma S A Viikari; Nanhua Zhang; Lydia A Bazzano; Trudy L Burns; Ronald J Prineas; Julia Steinberger; Elaine M Urbina; Alison J Venn; Olli T Raitakari; Terence Dwyer Journal: N Engl J Med Date: 2022-04-04 Impact factor: 176.079