USPSTF Advises Hypertension Screening for All Adults
Blood pressure should be measured outside clinical setting to confirm diagnosis before treatment
TUESDAY, June 23, 2020 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends screening all adults for hypertension with office-based blood pressure measurement (OBPM). This recommendation is included in a draft recommendation statement, published online June 23 by the USPSTF.
Janelle M. Guirguis-Blake, M.D., from the Kaiser Permanente Research Affiliates Evidence-Based Practice Center in Portland, Oregon, and colleagues conducted a systematic review to address the benefits and harms of screening for hypertension in adults. The researchers found that based on one community-based cluster randomized controlled trial of a multicomponent cardiovascular disease (CVD) health promotion program that included hypertension screening in older adults, there was a reduction in composite CVD-related hospital admissions (rate ratio, 0.91). For accuracy of initial OBPM, a meta-analysis of 15 studies demonstrated a pooled sensitivity and specificity of 0.54 and 0.90, respectively. Based on a meta-analysis of eight OBPM confirmation studies, pooled sensitivity and specificity were 0.80 and 0.55, respectively, for subsequent confirmatory blood pressure measurements; pooled sensitivity and specificity were 0.84 and 0.60, respectively, for home blood pressure monitoring confirmation studies. Thirteen studies suggested no decrements in quality of life or psychological distress.
Based on these findings, the USPSTF recommends hypertension screening for adults aged 18 years or older with OBPM (A recommendation). Before starting treatment, blood pressure measurements should be obtained outside of the clinical setting for diagnostic confirmation.
The draft recommendation statement and evidence review have been posted for public comment; comments can be submitted from June 23 to July 20, 2020.