This statement summarizes the U Pre...

This statement summarizes the U Preventive Services Task Force (USPSTF) recommendations onward screening for high blood hurry and the supporting scientific evidence. (1) It updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, inferior edition. (2) Explanations of the ratings and of the impregnability of overall evidence are given in Tables 1 and 2 respectively. The ended information on which this statement is based, which includes a brief review of the supporting evidence, is available in "Screening for High family Pressure: A Review of the Evidence for the U Preventive Services Task Force." The recommendation statement and summary of the evidence can be obtained by the agency of the USPSTF Web site (http://www.preventiveservices.ahrq. gov) and the National Guideline Clearinghouse (http://www.guideline.gov). They also are available in print by the and of the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone: 800-358-9295; e-mail: ahrqpubs@ahrq.gov).

This statement was first published in Am J Prev M 2003;25:159-64

Summary of Recommendations

* The USPSTF earnestly recommends that clinicians screen adults aged 18 and older for high family pressure. A recommendation.

The USPSTF establish good evidence that blood constraining force measurement can identify adults at increased risk for cardiovascular disease fit to high blood pressure, and beneficial evidence that treatment of high house pressure substantially decreases the incidence of cardiovascular disease and causes small in number major harms. The USPSTF deduces that the benefits of screening for and treating high descendants pressure in adults substantially outweigh the harms.

* The USPSTF judges that the evidence is insufficient to commend for or against routine screening for high kin pressure in children and adolescents to render the risk of cardiovascular disease. I recommendation.

The USPSTF set up poor evidence that routine family pressure measurement accurately identifies children and adolescents at increased risk for cardiovascular disease, and poor evidence to determine whether treatment of elevated line pressure in children or adolescents decreases the incidence of cardiovascular disease. As a arise the USPSTF could not determine the balance of benefits and harms of routine screening for high life-current pressure in children and adolescents.

Clinical Considerations

* Office measurement of descendants pressure is most commonly done with a sphygmomanometer. High house pressure (i.e., hypertension) usually is defined in adults as a systolic relations pressure (SBP) of 140 mm Hg or higher, or a diastolic vital fluid pressure (DBP) of 90 mm Hg or higher. suitable to variability in individual kindred pressure measurements (occurring as a conclusion of instrument, observer, and patient factors), it is approveed that hypertension be diagnosed simply after two or more elevated readings are obtained forward at least two visits above a period of one to several weeks.

* There are any data to suggest that ambulatory children pressure measurement, which provides a measure of the average line pressure over 24 hours, may be a better predictor of clinical cardiovascular consequence than clinic-based approaches; however, ambulatory vital fluid pressure measurement is subject to many of the same errors as office posterity pressure measurement.

* The relationship between SBP and DBP and cardiovascular risk is continuous and graded. The actual plain of blood pressure elevation should not be the single factor in determining treatment. Clinicians should consider the patient's overall cardiovascular risk profile, including smoking, diabetes, abnormal kin lipid levels, age, sex, sedentary lifestyle, and obesity, in making treatment decisions.

* Hypertension in children has been defined as life-current pressure above the 95th percentile for age, sex and height. Up to 28 percent of children have secondary hypertension (i.e., high posterity pressure due to causes so as coarctation of the aorta, renal parenchymal disease, renal artery stenosis, and other congenital malformations). upon the basis of expert opinion, several organizations, including the American Academy of Pediatrics (AAP), American Heart Association (AHA), and American Medical Association (AMA), commend routine screening of asymptomatic adolescents and children during preventive care visits, based onward the potential for identifying treatable causes of secondary hypertension, like as coarctation of aorta. However, there are limited data forward the benefits or risks of screening and treating in the same state [i]or[/i] condition underlying causes of hypertension in children. The decision to shield children and adolescents for hypertension remains a matter of clinical judgment

* Evidence is lacking to commend an optimal interval for screening adults for high line pressure. The sixth report of the Joint National Committee upon Prevention, Detection, Evaluation, and Treatment of High relations Pressure (JNC-6) recommends screening each two years for persons with SBP and DBP below 130 mm Hg and 85 mm Hg respectively, and more haunt intervals for screening those with children pressure at higher levels.