Fairfax Family Practice Residency, Fairfax, Virginia.
Virginia Commonwealth University, Richmond.
JAMA. 2020 Nov 10;324(18):1878-1883. doi: 10.1001/jama.2020.20122.
Prevalence of hypertension (both primary and secondary) in children and adolescents in the US ranges from 3% to 4%. Primary hypertension in children and adolescents occurs primarily in children older than 13 years and has no known cause but is associated with several risk factors, including family history and higher body mass index. Secondary hypertension occurs primarily in younger children and is most commonly caused by genetic disorders, renal disease, endocrine disorders, or cardiovascular abnormalities.
To update its 2013 recommendation, the USPSTF commissioned a review of the evidence on the benefits and harms of screening, test accuracy, the effectiveness and harms of treatment, and the association between hypertension and markers of cardiovascular disease in childhood and adulthood.
This recommendation statement applies to children and adolescents aged 3 to 18 years not known to have hypertension or who are asymptomatic.
The USPSTF concludes that the evidence to support screening for high blood pressure in children and adolescents is insufficient and that the balance of benefits and harms cannot be determined.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for high blood pressure in children and adolescents. (I statement).
美国儿童和青少年的高血压（原发性和继发性）患病率为 3%至 4%。儿童和青少年原发性高血压主要发生在 13 岁以上的儿童中，其病因不明，但与多种风险因素有关，包括家族史和较高的体重指数。继发性高血压主要发生在年幼的儿童中，最常见的原因是遗传疾病、肾脏疾病、内分泌疾病或心血管异常。
USPSTF 委托对筛查的益处和危害、检测准确性、治疗的有效性和危害以及高血压与儿童和成年期心血管疾病标志物之间的关系进行了评估，以更新其 2013 年的建议。
本建议声明适用于已知无高血压或无症状的 3 至 18 岁儿童和青少年。
USPSTF 得出结论，支持筛查儿童和青少年高血压的证据不足，无法确定其利弊平衡。
USPSTF 得出结论，目前的证据不足以评估筛查儿童和青少年高血压的利弊平衡。（I 级声明）。
