Evidence for the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure

Abstract

Background: High blood pressure is common, and screening is a well-established evidence-based standard of current medical practice.

Purpose: To perform a literature search for new, substantial evidence on screening for high blood pressure that would inform the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure.

Data sources: The PubMed and Cochrane databases were searched. The searches were limited to English-language articles on studies of adult humans (age >18 years) that were published between 1 October 2001 and 31 March 2006 in core clinical journals.

Study selection: For the literature on benefits, meta-analyses; systematic reviews; and randomized, controlled trials were included. For harms, meta-analyses; systematic reviews; randomized, controlled trials; cohort studies; case-control studies; and case series of large, multisite databases were included. Two reviewers independently reviewed titles, abstracts, and full articles for inclusion.

Data extraction: No new evidence was found on benefits or harms of screening. Two reviewers extracted data from studies on the harms of early treatment, including adverse effects of drug therapy and adverse quality-of-life outcomes.

Data synthesis: No new evidence was found for the benefits of screening for high blood pressure. New evidence on the harms of treatment of early hypertension shows that pharmacologic therapy is associated with common side effects; serious adverse events are uncommon.

Limitations: The nonsystematic search may have missed some smaller studies on the benefits and harms of screening and treatment for high blood pressure.

Conclusion: No new evidence was found on the benefits of screening. Pharmacotherapy for early hypertension is associated with common side effects.