Evidence to Support Universal Blood Pressure Screening in School-Based Clinical Settings

Abstract

BACKGROUND: Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states “there is limited evidence to support school-based measurement of children's BP.” We explored the utility school-based BP screening. METHODS: A cross-sectional sample of 4096 students ages 6 to 17 from Title 1 Miami-Dade Public Schools (50% female, 71% non-Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and sex. RESULTS: Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 =.08, p