The American Society of Pediatric Nephrology (ASPN) has expressed concern over the potential impact of the recent U.S. Preventive Services Task Force (USPSTF) Recommendation Statement regarding screening for primary hypertension in children and adolescents published online Oct. 8 in the Annals of Internal Medicine. The task force concluded that there was not enough evidence to properly weigh the benefits versus the risks of screening for primary hypertension in asymptomatic children and adolescents.
The ASPN said it is concerned the task force's statement may discourage primary care physicians from measuring blood pressure in children and teens as a routine part of their clinical practice.
"High blood pressure currently affects up to 5% of all children and adolescents in the United States," the ASPN said in a statement. "This number has increased over the last several decades along with the prevalence of obesity. Over a third of US children are now overweight and obese (corresponding to a staggering 24 million children) and up to 10% of these children have high blood pressure. Although current guidelines from the National High Blood Pressure Education Program (NHBPEP) call for measuring blood pressure in all children ages 3-17 at least once during every health care episode, evidence shows that on average providers measure blood pressure only 2/3 of the time during well-child visits and 1/3 of the time during sick visits. In addition, because of the complexity of determining normal values in children, elevated readings are only recognized about 15% of the time. Practitioners are already doing a poor job of recognizing high blood pressure in children. The ASPN fears that an attitude of complacency among physicians which may be generated by this report may further reduce the detection of hypertension in children."
The USPSTF said it found no direct evidence that routine blood pressure measurement accurately identifies children and adolescents who are at increased risk for cardiovascular disease in adulthood, and inadequate evidence to determine whether treatment of high blood pressure in children or adolescents led to sustained decreases in blood pressure.