Original Title: Efectividad, seguridad y evaluación económica de las diferentes alternativas existentes en la detección precoz de la hipertensión arterial en la edad pediátrica

Authors' objectives: The aim of this systematic review is to assess the available information related to the efficiency, effectiveness and safety of the screening for AHT in paediatric population.

Authors' results and conclusions: For the first research question (efficiency), one economic evaluation was identified. According to this study, population-based BP interventions are more costly and effective than routine BP screening for early cardiovascular disease prevention. For the second research question (effectiveness), no studies were identified for inclusion. A small selection of papers that show that the course and natural history of childhood hypertension remains unclear was discussed. These studies analyse the long-term consequences of hypertension in childhood by using surrogate markers of CVD in adulthood like hypertension or intima-media thickness. There is no expert consensus on the appropriateness of the screening for primary childhood hypertension. There is no evidence to assess the balance of benefits and harms of universal screening for hypertension in childhood to reduce cardiovascular risk in adulthood. There is no expert consensus on whether pediatric population should be routinely screened for primary hypertension.

Authors' recommendations: We recommend a single measurement of BP between the ages of 3 and 6 years to identify secondary hypertension, in the framework of the Infant Health Program. The rationale behind this recommendation is the potential benefit that might be associated to the early detection and treatment of an underlying condition.

Authors' methods: The following databases were searched: PubMed/MEDLINE, EMBASE, Lilacs; and the databases of the Centre for Reviews and Dissemination (CRD): NHS Economic Evaluation Database (NHS EED), Health Technology Assessment Database (HTA), Database of Abstracts of Reviews of Effects (DARE). In addition, the databases of the following government agencies, scientific societies and guidelines-developing organizations were also searched: U.S. Preventive Services Task Force, UK National Screening Committee, Canadian Task Force on Preventive Health Care, American Academy of Pediatrics, American Heart Association, Asociación Española de Pediatría y Asociación Española de Pediatría en Atención Primaria, GuiaSalud, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse. Subsequently, a manual search from the reference lists of previously identified references was conducted. Complete economic evaluation studies, experimental and observational studies with a comparison group published until March 2013, were selected for the review. No limits were applied for language. The selection of studies was done according to the previously defined inclusion and exclusion criteria. Those articles that met inclusion criteria were assessed by the computer-assisted critical appraisal tool of the Basque Office for Health Technology Assessment-OSTEBA.

Project Status: Completed

Year Published: 2016

URL for published report: https://www.iacs.es/wp-content/uploads/2017/05/756_IACS_HTA.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Health Sciences Institute in Aragon (IACS)

Contact Address: Avda, San Juan Bosco, 13, planta 2

Contact Name: María Pilar Calvo Pérez

Contact Email: direccion.iacs@aragon.es