Screening for High Blood Pressure in Children and Adolescents: US Preventive Services Task Force Recommendation Statement | Adolescent Medicine | JAMA | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.207.129.82. Please contact the publisher to request reinstatement.
1.
Gartlehner  G, Vander Schaaf  EB, Orr  C, Kennedy  SM, Clark  R, Viswanathan  M.  Screening for Hypertension in Children and Adolescents: Systematic Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 193. Agency for Healthcare Research and Quality; 2020. AHRQ publication 20-05261-EF-1.
2.
Dobson  CP, Eide  M, Nylund  CM.  Hypertension prevalence, cardiac complications, and antihypertensive medication use in children.   J Pediatr. 2015;167(1):92-97. doi:10.1016/j.jpeds.2015.04.016PubMedGoogle ScholarCrossref
3.
McNiece  KL, Poffenbarger  TS, Turner  JL,  et al.  Prevalence of hypertension and pre-hypertension among adolescents.   J Pediatr. 2007;150(6):640-644.Google ScholarCrossref
4.
Hansen  ML, Gunn  PW, Kaelber  DC.  Underdiagnosis of hypertension in children and adolescents.   JAMA. 2007;298(8):874-879. doi:10.1001/jama.298.8.874PubMedGoogle ScholarCrossref
5.
Chen  X, Wang  Y.  Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis.   Circulation. 2008;117(25):3171-3180. doi:10.1161/CIRCULATIONAHA.107.730366PubMedGoogle ScholarCrossref
6.
Flynn  JT, Pierce  CB, Miller  ER  III,  et al; Chronic Kidney Disease in Children Study Group.  Reliability of resting blood pressure measurement and classification using an oscillometric device in children with chronic kidney disease.   J Pediatr. 2012;160(3):434-440. doi:10.1016/j.jpeds.2011.08.071PubMedGoogle ScholarCrossref
7.
US Preventive Services Task Force. Procedure Manual. Accessed April 3, 2020. https://www.uspreventiveservicestaskforce.org/uspstf/procedure-manual
8.
Flynn  JT, Kaelber  DC, Baker-Smith  CM,  et al; Subcommittee on Screening and Management of High Blood Pressure in Children.  Clinical practice guideline for screening and management of high blood pressure in children and adolescents.   Pediatrics. 2017;140(3):e20171904. doi:10.1542/peds.2017-1904PubMedGoogle Scholar
9.
Whelton  PK, Carey  RM, Aronow  WS,  et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.   Circulation. 2018;138(17):e426-e483.PubMedGoogle Scholar
10.
Grossman  DC, Bibbins-Domingo  K, Curry  SJ,  et al; US Preventive Services Task Force.  Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement.   JAMA. 2017;317(23):2417-2426. doi:10.1001/jama.2017.6803PubMedGoogle ScholarCrossref
11.
Bibbins-Domingo  K, Grossman  DC, Curry  SJ,  et al; US Preventive Services Task Force.  Screening for lipid disorders in children and adolescents: US Preventive Services Task Force recommendation statement.   JAMA. 2016;316(6):625-633. doi:10.1001/jama.2016.9852PubMedGoogle ScholarCrossref
12.
Moyer  VA; US Preventive Services Task Force.  Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement.   Pediatrics. 2013;132(5):907-914. doi:10.1542/peds.2013-2864PubMedGoogle ScholarCrossref
13.
Gartlehner  G, Vander Schaaf  EB, Orr  C, Kennedy  SM, Clark  R, Viswanathan  M.  Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.   JAMA. Published November 10, 2020. doi:10.1001/jama.2020.11119Google Scholar
14.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents.  Pediatrics. 2004;114(2 suppl 4th report):555-576. PubMedCrossref
15.
Xi  B, Zhang  T, Li  S,  et al.  Can pediatric hypertension criteria be simplified? a prediction analysis of subclinical cardiovascular outcomes from the Bogalusa Heart Study.   Hypertension. 2017;69(4):691-696. doi:10.1161/HYPERTENSIONAHA.116.08782PubMedGoogle ScholarCrossref
16.
Du  T, Fernandez  C, Barshop  R, Chen  W, Urbina  EM, Bazzano  LA.  2017 pediatric hypertension guidelines improve prediction of adult cardiovascular outcomes.   Hypertension. 2019;73(6):1217-1223. doi:10.1161/HYPERTENSIONAHA.118.12469PubMedGoogle ScholarCrossref
17.
Hoq  S, Chen  W, Srinivasan  SR, Berenson  GS.  Childhood blood pressure predicts adult microalbuminuria in African Americans, but not in whites: the Bogalusa Heart Study.   Am J Hypertens. 2002;15(12):1036-1041. doi:10.1016/S0895-7061(02)03066-2PubMedGoogle ScholarCrossref
18.
Burrello  J, Erhardt  EM, Saint-Hilary  G,  et al.  Pharmacological treatment of arterial hypertension in children and adolescents: a network meta-analysis.   J Hypertens. 2019;37:72(2):306-313. doi:10.1161/HYPERTENSIONAHA.118.10862PubMedGoogle Scholar
19.
Son  WM, Sung  KD, Bharath  LP, Choi  KJ, Park  SY.  Combined exercise training reduces blood pressure, arterial stiffness, and insulin resistance in obese prehypertensive adolescent girls.   Clin Exp Hypertens. 2017;39(6):546-552. doi:10.1080/10641963.2017.1288742PubMedGoogle ScholarCrossref
20.
Hansen  HS, Froberg  K, Hyldebrandt  N, Nielsen  JR.  A controlled study of eight months of physical training and reduction of blood pressure in children: the Odense Schoolchild Study.   BMJ. 1991;303(6804):682-685. doi:10.1136/bmj.303.6804.682PubMedGoogle ScholarCrossref
21.
Couch  SC, Saelens  BE, Levin  L, Dart  K, Falciglia  G, Daniels  SR.  The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure.   J Pediatr. 2008;152(4):494-501. doi:10.1016/j.jpeds.2007.09.022PubMedGoogle ScholarCrossref
22.
Berenson  GS, Voors  AW, Webber  LS,  et al.  A model of intervention for prevention of early essential hypertension in the 1980s.   Hypertension. 1983;5(1):41-54. doi:10.1161/01.HYP.5.1.41PubMedGoogle ScholarCrossref
23.
Berenson  GS, Shear  CL, Chiang  YK, Webber  LS, Voors  AW.  Combined low-dose medication and primary intervention over a 30-month period for sustained high blood pressure in childhood.   Am J Med Sci. 1990;299(2):79-86. doi:10.1097/00000441-199002000-00001PubMedGoogle ScholarCrossref
24.
Flynn  JT, Daniels  SR, Hayman  LL,  et al; American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young.  Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association.   Hypertension. 2014;63(5):1116-1135. doi:10.1161/HYP.0000000000000007PubMedGoogle ScholarCrossref
25.
Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute.  Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report.   Pediatrics. 2011;128(suppl 5):S213-S256. doi:10.1542/peds.2009-2107CPubMedGoogle ScholarCrossref
26.
American Academy of Family Physicians. Clinical preventive service recommendation: hypertension, children and adolescents. Accessed April 3, 2020. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/hypertension.html
US Preventive Services Task Force
Recommendation Statement
November 10, 2020

Screening for High Blood Pressure in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force
JAMA. 2020;324(18):1878-1883. doi:10.1001/jama.2020.20122
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)

×