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U.S. Task Force Stands by Hypertension Recommendation

Literature search finds no new evidence on screening benefits or harms

TUESDAY, Dec. 4 (HealthDay News) -- Following a literature search on the benefits and harms of screening for hypertension in adults and the harms of early treatment, the U.S. Preventive Services Task Force (USPSTF) found no reason to change its 2003 recommendation that supported screening. The research is published in the Dec. 4 issue of the Annals of Internal Medicine.

Tracy Wolff, MD, and Therese Miller, of the Agency for Healthcare Research and Quality in Rockville, Md., searched the PubMed and Cochrane databases for studies on adults published between Oct. 1, 2001 and March 31, 2006 in core clinical journals. They found no new studies on the benefits or harms of screening that met their inclusion criteria. They included five studies evaluating the harms of early treatment for hypertension. According to these, pharmacologic therapy is associated with common side effects, but serious adverse events are uncommon.

In an accompanying recommendation statement, the USPSTF gives a grade A recommendation to screening for high blood pressure in adults aged 18 and older without known hypertension, due to good evidence that it can identify adults at higher risk for cardiovascular disease due to hypertension. Treatment for hypertension in adults is shown to substantially lower the incidence of cardiovascular events, with few major harms.

The task force didn't recommend an optimal screening interval. However, "The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends screening every two years in persons with blood pressure less than 120/80 mm Hg and every year in persons with systolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 90 mm Hg," the authors write.

Abstract - Wolff
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Abstract - USPSTF
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