Document Detail

Screening for elevated blood pressure in children and adolescents: a critical appraisal.
MedLine Citation:
PMID:  23303490     Owner:  NLM     Status:  MEDLINE    
Although screening for elevated blood pressure (BP) in adults is beneficial, evidence of its beneficial effects in children is not clear. Elevated BP in children is associated with atherosclerosis early in life and tracks across the life course. However, because of the high variability in BP, tracking is weak, and having an elevated BP in childhood has a low predictive value for having elevated BP later in life. The absolute risk of cardiovascular diseases associated with a given level of BP in childhood and the long-term effect of treatment beginning in childhood are not known. No study has experimentally evaluated the benefits and harm of BP screening in children. One modeling study indicates that BP screen-and-treat strategies in adolescents are moderately cost-effective but less cost-effective than population-wide interventions to decrease BP for the reduction of coronary heart diseases. The US National Heart, Lung, and Blood Institute and the European Society of Hypertension recommend that children 3 years of age and older have their BP measured during every health care visit. According to the US Preventive Services Task Force, there is no sufficient evidence to recommend for or against screening, but their recommendations have to be updated. Whether the benefits of universal BP screening in children outweigh the harm has to be determined. Studies are needed to assess the absolute risk of cardiovascular diseases associated with elevated BP in childhood, to evaluate how to simplify the identification of elevated BP, to evaluate the long-term benefits and harm of treatment beginning in childhood, and to compare universal and targeted screening strategies.
Arnaud Chiolero; Pascal Bovet; Gilles Paradis
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  JAMA pediatrics     Volume:  167     ISSN:  2168-6211     ISO Abbreviation:  JAMA Pediatr     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-05     Completed Date:  2013-04-18     Revised Date:  2014-06-19    
Medline Journal Info:
Nlm Unique ID:  101589544     Medline TA:  JAMA Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  266-73     Citation Subset:  AIM; IM    
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MeSH Terms
Cost-Benefit Analysis
Evidence-Based Medicine
Hypertension / complications,  diagnosis*,  therapy
Mass Screening* / economics
Practice Guidelines as Topic
Reference Values
Comment In:
J Clin Hypertens (Greenwich). 2014 May;16(5):342-3   [PMID:  24720583 ]
JAMA Pediatr. 2013 Mar 1;167(3):302-4   [PMID:  23303514 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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