Clinical inquiries. Does blood pressure screening benefit children?

Abstract

Screening may not show benefits in childhood but could pay off for adults. Although major professional organizations recommend measuring blood pressure (BP) at every clinic visit for all children older than 3 years (strength of recommendation [SOR]: C, expert opinion), scant evidence links earlier detection and treatment of childhood hypertension with improved patient-oriented outcomes. However, detecting childhood hypertension may help identify adults who would benefit from earlier treatment. Children with elevated BP have a more than 60% chance of being hypertensive as young adults (SOR: B, prospective cohort study). Children with systolic BP above the 95th percentile had a more than 4-fold increase in coronary artery disease as adults compared with children below the 95th percentile (SOR: B, retrospective study). Identifying hypertension in children is associated with a 15-fold greater likelihood of hypertension in their parents (SOR: B, case series).