High blood pressure in children and adolescents nearly doubled between 2000 and 2020

According to this study, obesity is a contributing factor to the increase in childhood hypertension, with almost 19% of obese children and adolescents suffering from high blood pressure, compared to less than 3% of healthy weight children and adolescents.

“This increase over the past 20 years should be a warning to health professionals and carers,” says study author Igor Rudan, director of the Center for Global Health Research at the Usher Institute at the University of Edinburgh, UK. “But the good news is that we can take steps now, including improved screening and prevention, to control high blood pressure in children and reduce the risk of further health complications in the future.”

The meta-analysis considered data from 96 studies involving more than 443,000 children from 21 countries.researchers verified that the method of measuring blood pressure in children and adolescents can influence prevalence estimates, ranging from 4.3% when hypertension was confirmed during at least three in-person visits to 6.7% when out-of-office assessments were included.

For example, the study highlights that masked hypertension, in which high blood pressure is not detected during routine testing, affects nearly 9.2% of children and adolescents worldwide and may be underdiagnosed. Similarly, white coat hypertension (a condition in which blood pressure is elevated only in a medical setting such as a clinic, but is normal when measured at home or with a home blood pressure monitor) is estimated to be 5.2%, suggesting that a significant proportion of children may be misdiagnosed.

Misdiagnosis

“Children’s hypertension is more common than previously thought, and relying solely on traditional in-office blood pressure measurements may underestimate the true prevalence or lead to misdiagnoses of hypertension in children and adolescents. To identify hypertension or children at risk of developing hypertension, early Detection and better access to prevention and treatment options are more important than ever. Addressing hypertension in childhood is essential to prevent future health complications during the transition to adulthood,” said study author Paige Song, professor of medicine at Zhejiang University in China.

The report suggests that children and adolescents with obesity are almost eight times more likely to develop high blood pressure. Approximately 19% of obese children have the disease, compared to 2.4% of healthy-weight children and adolescents.

The study also suggests that an additional 8.2% of children and adolescents have prehypertension. This means that although their blood pressure levels are higher than normal, they do not yet meet the diagnostic criteria for hypertension. Prehypertension is particularly common in adolescence, reaching approximately 11.8% in adolescents and approximately 7% in younger children.

Blood pressure levels also tend to rise rapidly during early adolescence, peaking around age 14, especially in boys. This pattern highlights the importance of regular blood pressure checks during this critical period. Children and adolescents with prehypertension are more likely to develop hypertension.

In a related comment, lead author Rahul Chankrani of Canada’s McMaster University, who was not involved in the study, said: “The challenge is clear: to ensure that childhood hypertension remains undetected, unrecognized and untreated.”