title: Performance of parental history for the targeted screening of hypertension in children.
abstract: OBJECTIVE
  Several guidelines recommend universal screening for hypertension in childhood and adolescence. Targeted screening to children with parental history of hypertension could be a more efficient strategy than universal screening. Therefore, we assessed the association between parental history of hypertension and hypertension in children, and estimated the sensitivity, specificity, negative, and positive predictive values of parental history of hypertension for hypertension in children.
  
  
  METHODS
  The present study was a school-based cross-sectional study including 5207 children aged 10-14 years from all public 6th grade classes in the Canton of Vaud, Switzerland. Children had hypertension if they had sustained elevated blood pressure over three separate visits.
  
  
  RESULTS
  In children, the prevalence of hypertension was 2.2%. Some 8.5% of mothers and 12.9% of fathers reported to be hypertensive. Maternal history of hypertension (odds ratio 2.0, 95% confidence interval 1.2-3.3) and paternal history of hypertension (odds ratio 2.2, 95% confidence interval 1.4-3.6) were independent risk factors for hypertension in children. Nevertheless, the sensitivity of parental history of hypertension for the identification of hypertension in children was low (from 4% for both parents' positive history up to 41% for at least one parent's positive history). Positive predictive values were also low (between 4 and 5%).
  
  
  CONCLUSIONS
  Children with hypertensive parents were at higher risk of hypertension. Nevertheless, parental history of hypertension helped only marginally to identify hypertension in offspring. Targeting screening only toward children with a parental history of hypertension may not be a substantially better strategy to identify hypertension in children compared with universal screening.
authors: aDepartment of Pediatrics bInstitute of Social and Preventive Medicine cService of Nephrology, Lausanne University Hospital, Lausanne, Switzerland.
authors: Clemens
authors: C
authors: Bloetzer
authors: Fred
authors: F
authors: Paccaud
authors: Michel
authors: M
authors: Burnier
authors: Pascal
authors: P
authors: Bovet
authors: Arnaud
authors: A
authors: Chiolero
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016017:Odds Ratio; D018579:Patient Selection; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology