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One Step Further Toward a Targeted Screening Program.

See related article, pp 435–442 

The old controversy on universal screening for high blood pressure in childhood has intensified since the US Preventive Task Force recommended not to screen for hypertension in asymptomatic children in 2013.1 The reasoning at the time was that “the current evidence is insufficient to assess the balance of benefits and harms in asymptomatic children and adolescents to prevent subsequent cardiovascular disease in adulthood.”1 Furthermore, the prevalence of hypertension in childhood was viewed as very low and the risk of false-positive results as too high.1 This view contrasts the recommendations by many medical experts and medical societies. Only recently the European Society of Hypertension published updated guidelines and recommended screening for high blood pressure starting at the age of 3 years, with a reevaluation in children with prehypertensive values after 1 year.2 The argument that was put forward, considering the noninvasive, noncostly, and easy to perform measurement, is that “lack of evidence does not necessarily justify inaction.”2

The article published in this issue of Hypertension by Hao et al3 adds to the evidence and supports arguments for blood pressure screening in youth. Adopting a new approach to identify children who will develop high blood pressure in adulthood, the authors applied latent class analyses to identify clusters of individuals who develop similar blood pressure trajectories from childhood into young adulthood using data from the Georgia Stress and Health Study, a longitudinal study on the development of cardiovascular disease. The analyses were …