Screening for high blood pressure: a review of the evidence for the U.S. Preventive Services Task Force.

CONTEXT: In 1996, the U.S. Preventive Services Task Force (USPSTF) recommended screening adults for hypertension. Since that time, the published literature on hypertension has expanded rapidly, necessitating a new examination of the evidence supporting screening. OBJECTIVE: Update the 1996 evidence review on screening for hypertension. DATA SOURCES: The 1996 Guide to Clinical Preventive Services, recent systematic reviews, and focused searches of MEDLINE were used to identify new evidence relevant to detecting and treating hypertension. STUDY SELECTION: When a good quality, recent systematic review was available, it was used to summarize previous research; MEDLINE was searched only for more recent articles. Two authors reviewed abstracts (and full texts, if necessary) of potentially relevant articles to determine if they should be included. DATA EXTRACTION: One author extracted data from included studies into evidence tables. DATA SYNTHESIS: Hypertension can be effectively detected through office measurement of blood pressure. Treatment of elevated blood pressure in adults can reduce cardiovascular events. The magnitude of risk reduction depends on the degree of hypertension and the presence of other cardiovascular risk factors. Available studies have found no important adverse effects on psychological well-being and mixed effects on the absenteeism rates of adults who are screened and labeled as being hypertensive. CONCLUSIONS: Substantial indirect evidence supports the effectiveness of screening adults to detect hypertension and treating them to reduce cardiovascular disease.

Duke Scholars

Author Michael Patrick Pignone Medicine, General Internal Medicine