Screening for high blood pressure in adults: a systematic evidence review for the U.S. Preventive Services Task Force
Piper MA, Evans CV, Burda BU, Margolis KL, O'Connor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP
Record ID 32015000400
English
Authors' objectives:
We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for high blood pressure (BP) in nonpregnant adults.
Authors' recommendations:
ABPM (24-hour, daytime, or nighttime) is a better predictor of long-term CV outcomes than OBPM (usually manual sphygmomanometry) and should be considered the reference standard for evaluating noninvasive BP measurements. A small body of evidence suggests, but does not confirm, that HBPM can serve as a similar predictor of outcomes. Initial screening by office-based methods (manual sphygmomanometry or automated oscillometric devices) variably predicts hypertension as defined by ABPM, resulting in a significant population with isolated clinic hypertension. Limited evidence suggests that patients with isolated clinic hypertension have outcomes that are more similar to normotensive than hypertensive persons. Failure to confirm initial elevated OBPM results may result in misdiagnosis and overtreatment. Limited evidence suggests that repeated measurements and improved procedural control (e.g., by automation) may improve the diagnostic accuracy of OBPM when used to screen for high BP or confirm a diagnosis of hypertension. Studies of
rescreening intervals at up to 6 years found a higher incidence of hypertension overall and at shorter intervals for persons with BP in the high-normal range, older adults, persons with an above normal BMI, and African Americans. These studies showed much lower incidence at longer rescreening intervals up to 6 years in persons without these risk factors.
Details
Project Status:
Completed
Year Published:
2014
URL for published report:
http://www.ncbi.nlm.nih.gov/books/NBK269495/pdf/TOC.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Mass Screening
- Adult
- Blood Pressure Determination
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.