The review included 34 studies.
Diagnostic accuracy: Two fair-quality studies were found. One used office-based measurement, with 24-hour ambulatory measurement as the reference standard. This found a sensitivity of 65% (95% CI 45 to 80) and a specificity of 75% (95% CI 63 to 84). The other study measured initial blood pressure with persistent elevation of blood pressure as the reference standard. This one found a sensitivity of 72% (95% CI 65 to 78) and a specificity of 92% (95% CI 91 to 92).
Association between childhood and adult hypertension: Ten studies were found. In three studies, the sensitivity of childhood hypertension in predicting adult hypertension ranged from zero to 63% and specificity from 77% to 100%, depending on the threshold used to define hypertension. Five studies reported significant associations between high childhood blood pressure and adult hypertension, with odds ratios ranging from 1.1 to 4.5. Two studies reported conflicting findings on the association of childhood blood pressure and carotid intima media thickness in young adulthood.
Efficacy of interventions: Fourteen fair-quality RCTs were found. Seven trials evaluated different drugs, mostly compared with placebo. Most trials reported more children reaching target blood pressure on the active drug (range 15% to 86%, compared with 26% to 47% on placebo). Most trials reported significant decreases in systolic (1.9 to 10.2 mmHg) and diastolic (0.4 to 8.1 mmHg) blood pressure. Six trials examined lifestyle interventions. Only one small trial of physical education found a significant reduction in blood pressure with the intervention, compared with control. One trial found a benefit of a low-sodium diet for girls but not for boys.
Adverse effects of treatment: Twelve trials were found; 11 were of fair quality and one was good. Adverse effects were generally poorly reported. Five trials of monotherapy found no difference in adverse effect rates between intervention and placebo. Two reports pooled data across trials and found similar rates of adverse effects across treatment groups.
Other results were reported, mostly for single studies, or noting where no studies were available. In particular, the authors reported that no studies were found that examined if screening for childhood hypertension reduced their adverse health outcomes.