Screening for Hypertension in Adolescents

Hypertension, or high blood pressure, is a considerable bother for the US healthcare system due to high prevalence and morbidity and mortality implications. However, the US Preventative Service Task Force (USPSTF, 2019b) concludes that there is not enough evidence to suggest screening for primary hypertension in adolescents due to the uncertainty of balance between harms and benefits.

In particular, screening for hypertension is associated with an increased number of false-positive results due to the normalization of blood pressure (Sharma, 2017). However, USPSTF (2019b) suggests that adolescents with increased risk of hypertension, such as obesity and family history of the condition, undergo preventative screening. Blood pressure should be measured using a manual sphygmomanometer, and hypertension should be diagnosed if SBP or DBP at or above the 95th percentile (Sharma, 2017).

Stage 1 hypertension (SBP or DBP from 95th to 99th percentile, plus 5 mm Hg) should be treated with lifestyle interventions, such as weight reduction, dietary changes, and increased physical activity. Stage 2 hypertension (BP or DBP >99th percentile, plus 5 mm Hg) should be addressed with medications and lifestyle interventions. However, USPSTF (2019a) strongly recommends obtaining measurements outside of the clinical setting for diagnostic confirmation on regular basis for preventing hypertension in adults.

References

Sharma, A. (2017). Hypertension in adolescents. In M. Goldstein (Ed.), The MassGeneral Hospital for Children Adolescent Medicine Handbook (pp. 119-129). Cham, Switzerland: Springer.

US Preventative Service Task Force. (2019a). High blood pressure in adults: Screening. Web.

US Preventative Service Task Force. (2019b). Blood pressure in children and adolescents (hypertension): Screening. Web.