Seeking a Crystal Ball for Kids' Hearts

High blood pressure screening in children and teens not helpful in preventing heart disease

(RxWiki News) Identifying early warning signs should assist doctors in helping their patients avoid future disease. However, it is possible to look too hard – and not really find anything helpful.

A recent study looked at the research evidence related to screening children and teenagers for high blood pressure.

The review of the research dealt only with those children and teens who did not already show symptoms of high blood pressure. The researchers hoped to find to find out if screening might help prevent heart disease.

However, the researchers did not find any evidence to support early high blood pressure screening. They concluded more research is necessary before we can know if high blood pressure screening offers a chance to prevent heart disease later.

"Ask your doctor about risk factors for heart disease."

The study, led by Matthew Thompson, MD, MPH, of the Oregon Evidence-Based Practice Center at Oregon Health and Science University in Portland, aimed to determine whether screening children and teens for high blood pressure can help prevent later heart disease.

The authors reviewed all the trials and observational studies they were able to find that included children and teens who did not already show symptoms of heart disease or high blood pressure.

The reviewers investigated the accuracy of the blood pressure measurements, how effective the high blood pressure screening was and any possible harms that resulted from screening.

None of the studies they located actually looked at the effects of high blood pressure screening on later health outcomes. Therefore, there was no evidence to show that screening for high blood pressure could lead currently healthy individuals to be healthier or less healthy later on.

Two studies showed only moderate accuracy for measuring blood pressure levels.

Another seven studies compared the accuracy of blood pressure screenings during individuals' childhoods to their blood pressure measurements as adults. These studies found a wide range of results.

Three studies compared the results of blood pressure screening in childhood to later measurements related to the individuals' thickening of the arteries or protein in their urine, an indication of various possible health problems. However, the results of these studies were inconsistent.

Another seven studies looked at the impact of using medications to reduce blood pressure in teenagers over short periods of time.

These studies found that using medication to control the teens' blood pressure was effective and did not show serious side effects.

The researchers concluded that we do not currently have enough evidence to say that it is valuable to screen children or teenagers for high blood pressure to prevent later heart disease, as long as the children do not currently show symptoms.

"There is no direct evidence that screening for hypertension in children and adolescents reduces adverse cardiovascular outcomes in adults," the researchers wrote.

However, this study does not mean that screening some children for heart disease is never worthwhile, according to Sarah Samaan, MD, a cardiologist with Legacy Heart Center in Dallas-Fort Worth and a dailyRx expert..

"Without a doubt, unhealthy lifestyles in kids can lead to high blood pressure," Dr. Samaan said. "This is now occurring in unprecedented numbers. We know that the heart will show measurable changes in these children — changes that we used to see only in middle age. It's highly likely that these abnormalities will lead to higher rates of coronary heart disease, heart failure, kidney failure and stroke earlier in adult life, although the correlation has not yet been proven."

She pointed out other ways screenings provide information for some children.

"It's also important to understand that screening for high blood pressure can sometimes identify important congenital cardiovascular conditions, so we shouldn't take this analysis to mean that screening for blood pressure in children is not important," Dr. Samaan said.

The study was published February 25 in the journal Pediatrics. The research was funded by the Agency for Healthcare Research Quality for the US Preventive Services Task Force. The authors declared no conflicts of interest.

Review Date: 
February 23, 2013