28/07/2022
Screeening
Screening strategies for hypertension: a systematic review protocol
Bey-Marrié Schmidt,1 Solange Durão,1 Ingrid Toews,2 Charlotte M Bavuma,3 Joerg J Meerpohl,2 and Tamara Kredo1,4
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Abstract
Introduction
It is unclear whether early detection of hypertension, through screening, leads to healthier behaviours and better control of blood pressure levels. There is a need to learn from studies that have assessed the impact of different screening approaches on patient important outcomes. This systematic review protocol outlines the methods that will be used to assess the comparative effectiveness of different screening strategies (mass, targeted or opportunistic) for hypertension to reduce morbidity and mortality associated with hypertension.
Methods and analysis
We will primarily search Cochrane Central Register of Controlled Trials, Medline, Embase and Latin American and Caribbean Health Sciences Literature (LILACS). Relevant randomised controlled trials, controlled before and after, interrupted time series and prospective analytic cohort studies regardless of publication date, language and geographic location, will be included. We are interested in clinical, adverse event and health system outcomes. Two reviewers will independently screen titles, abstracts and full-text articles against inclusion criteria; perform data extraction and assess risk of bias in included studies. We will assess the certainty of the overall evidence using the Grading of Recommendations Assessment, Development and Evaluation approach and report findings accordingly.
Ethics and dissemination
No ethics approval will be sought, as only secondary studies will be used. Findings will be disseminated through peer-reviewed publication and conference presentations.
PROSPERO registration number
CRD42018093046.
Keywords: hypertension, mass screening, targeted screening, opportunistic screening
Strengths and limitations of this study
This systematic review is a response to priority setting conducted in collaboration with policy-makers who recognised a gap in available synthesised evidence regarding approaches for hypertension screening (mass, opportunities or targeted screening strategies).
This review will include randomised and non-randomised controlled studies to capture all relevant evidence regarding programmes of hypertension screening.
We will conduct a comprehensive search across several databases without restricting for language or publication status.
We plan to meta-analyse outcome data; however, included studies may vary in terms of study design and the outcomes reported, and therefore we may present narrative evidence syntheses.
The review authors have complementary expertise in systematic review methods and content which will ensure a review that is relevant for policy and practice.
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Background
Description of the condition
Hypertension, also known as raised or high blood pressure, is a long-term non-communicable medical condition, where the blood pressure in the arteries is persistently elevated.1 Blood pressure can be expressed as two measurements, systolic blood (SBP) and diastolic blood (DBP) pressures which are the minimum and maximum pressures. Table 1 compares previous versus new thresholds for high blood pressures.2
Table 1
Current versus newly recommended thresholds for hypertension screening
BP category SBP DBP
Previous guidelines
High ≥140 mm Hg and ≥90 mm Hg
New guidelines
Normal
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