It's not easy to wrangle fifth graders from noisy school hallways to get their blood pressure checked. But with an age-adjusted death rate due to heart disease substantially above the national average, West Virginia has a good reason to try.
In CARDIAC (Coronary Artery Risk Detection In Appalachian Communities), researchers collected blood pressure data on more than 62,000 West Virginia fifth graders and found that 12,245, or 19.7 percent, fall into the 95th percentile or above for blood pressure readings, based on norms for height and gender. Those children are considered to have high blood pressure.
"No other state is doing as comprehensive screening as we are," said Valerie Evans Minor, associate director for surveillance and co-founder of CARDIAC. "But with that comprehensive screening comes challenges."
Among them are school nurses with heavy caseloads. "Prevention often has to take a back seat to acute or even chronic care," Minor said.
Researchers in CARDIAC adapted by using upper-level students in the health sciences to help do readings.
Another challenge is the chaotic school environment which can be far from the ideal quiet setting recommended for measuring blood pressure.
Minor said it's important to be realistic about what screening programs can achieve. "They do not diagnose," she said. "Screening is better than missing the opportunity altogether for finding kids at risk. Ideal assessment can be done in follow-up in a more controlled environment."