The U.S. Preventive Services Task Force has posted a draft statement (subject to change after a public comment period) on screening for hypertension in children and adolescents, saying evidence is insufficient to recommend screening.
Hypertension in children and teens has increased in recent years, in part because of the rise in childhood obesity, according to a USPSTF news release. However, there is not enough solid evidence to recommend screening for hypertension because predicting which children and teens will develop the condition as adults is difficult.
The evidence is equally unclear as to whether lowering blood pressure in youth leads to improved cardiovascular health in adulthood. As such, screening for hypertension in children and adolescents has been given an “”I” designation, which the Task Force issues when there is not enough solid evidence to make a recommendation.
“The task force recognizes the importance of cardiovascular health,” task force member Kirsten Bibbins-Domingo, MD, PhD, said in the news release. “But for children and teens who show no other signs or symptoms of high blood pressure or an underlying health problem, there is not enough solid evidence to recommend that they should be screened for the condition.”
An “I” statement is not a recommendation for or against screening, but signifies there is not enough evidence to say definitively whether screening results in more benefit than harm.
In the absence of clear evidence, healthcare professionals should consider a number of things: the current scientific research, expert opinion, their own knowledge and experience, the patients health history and the values and preference of the patient and family.
The draft statement applies only to children and teens who show no other signs or symptoms suggestive of an underlying health problem, the USPSTF noted. In addition, the scope of the recommendation includes only primary hypertension and not secondary hypertension, which generally is caused by an underlying condition that is accompanied by a range of different symptoms. The treatment of secondary hypertension is likely to be handled as part of the management of the underlying condition.
“The task force calls on the research community to prioritize studies on screening and treatment of high blood pressure in children and teens and on the impact such interventions may have on cardiovascular health as these children and teens become adults,” Bibbins-Domingo said. “Investments in such research may lead to improved cardiovascular health for Americans and to a definitive recommendation from the task force in the future.”
A public comment period on the draft statement is open until March 25. All public comments will be considered as the USPSTF develops its final recommendation.
To read the draft statement and for a link to comment, visit www.uspreventiveservicestaskforce.org/draftrec2.htm.