07 May USPSTF: Recommends All Adults Be Screened for Hypertension
MedicalResearch.com Interview with:
Dr. Wong
John B. Wong, M.D.
Chief Scientific Officer
Vice chair for Clinical Affairs
Chief of the Division of Clinical Decision Making and
Primary care Clinician
Department of Medicine at Tufts Medical Center
MedicalResearch.com: What is the background for this study?
Response: Hypertension affects nearly half of all adults in the United States and is a major risk factor for many serious health conditions. Fortunately, by screening all adults for hypertension, clinicians can improve their patient’s health. The Task Force continues to recommend screening all adults for hypertension so that they can get the care they need to help prevent health conditions such as heart attack, stroke, and kidney failure.
MedicalResearch.com: What are the main findings? At what age should patients consider getting their blood pressure checked? How often?
Response: Hypertension can increase an individual’s risk for heart attacks, heart disease, strokes, and kidney disease. To prevent those serious conditions from occurring, the Task Force recommends that all adults who are 18 and older be screened for hypertension. The Task Force suggests that those 40 and over, and those at increased risk for hypertension, be screened annually. Risk factors for hypertension include older age, family history, excess weight, lifestyle habits, and dietary factors. For adults between the ages of 18 and 39 with no existing risk factors, screening is still recommended but can be done less often.
In all cases, screening for hypertension should first be done at the clinician’s office. If blood pressure is high, it should be measured outside of the office. If someone’s blood pressure outside of the office is also high, the clinician will diagnose hypertension that should then be treated.
MedicalResearch.com: What should readers take away from your report?
Response: Individuals usually cannot feel when they have high blood pressure, so most people would not know they have hypertension, or repeatedly high blood pressure measurements, unless they were screened or had a heart attack or stroke caused by hypertension. Screening allows hypertension to be identified and treated in a timely manner, so patients can be connected to the care they need to help them live longer, healthier lives.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: More research is needed on whether screening for other types of hypertension can improve health. For example, blood pressure readings could only be high in the clinician’s office but not at home, or blood pressure readings could only be high at home but not in the clinician’s office. The Task Force calls for more research for these other types of hypertension and for optimal screening approaches for all types of hypertension in diverse and underrepresented populations.
MedicalResearch.com: Is there anything else you would like to add?
Response: What’s really important to remember is that many people in America have hypertension that can be silent and undiagnosed until too late, when a heart attack or stroke occurs. The science and evidence show that adults should have blood pressure screening at their clinician’s office. If the blood pressure is high, they should talk with their clinician about having their blood pressure re-checked outside of the clinician’s office. This clarifies whether someone has high blood pressure readings only in the office or has high blood pressure readings in the office and in other settings. This difference helps clinicians know how best to care for their patients. Additionally, we recognize that not all hypertension screening approaches outside of the office are feasible for everyone, so we encourage healthcare clinicians to talk with their patients about what works best for them.
Citations:
Guirguis-Blake JM, Evans CV, Webber EM, Coppola EL, Perdue LA, Weyrich MS. Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(16):1657–1669. doi:10.1001/jama.2020.21669
US Preventive Services Task Force
US Preventive Services Task Force; Alex H. Krist, MD, MPH; Karina W. Davidson, PhD, MASc; Carol M. Mangione, MD, MSPH; Michael Cabana, MD, MA, MPH; Aaron B. Caughey, MD, PhD; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Chyke A. Doubeni, MD, MPH; Martha Kubik, PhD, RN; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Michael Silverstein, MD, MPH; James Stevermer, MD, MSPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD
USPSTF Recommendation: Screening for Hypertension in Adults
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Last Updated on May 7, 2021 by Marie Benz MD FAAD