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

Objective: The majority of elevated blood pressure (BP) in children/adolescents remains undiagnosed. The American Academy of Pediatrics states "there is limited evidence to support school-based measurement of children's BP." We explored the clinical/public health utility of providing BP screening in school health clinics. Methods: A cross-sectional sample of 4096 students ages 6-to-17 from Title 1 Miami-Dade County Public Schools (50% female, 71% non-Hispanic Black, 26% Hispanic, mean age 12.0 [CI 95%: 11.90-12.09]) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016-17 or 2017-18 school years. Relative risks (RRs) were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and sex. Results: Over a quarter (26.4%) of the sample had at least one elevated BP measurement, of which 59% were not obese. Students that were female, Hispanic, and obese showed an increased relative risk of elevated BP. RR for obese status was significant for all categories of elevated BP (all RRs >1.88, all p