Between 2000 and 2020, the number of children and adolescents with high blood pressure worldwide nearly doubled.
This is demonstrated by a meta-analysis published in The Lancet Child & Adolescent Health, which shows that in 2000, approximately … 3.2% of children suffer from high blood pressure, and this number rose in 2020 to more than 6.2% among those under the age of 19 years. It is estimated that there are 114 million young people in the world who suffer from high blood pressure.
According to the study, obesity is a driving factor for increased high blood pressure in children, as approximately 19% of children and adolescents with obesity suffer from high blood pressure, compared to less than 3% in children and adolescents of a healthy weight.
“This increase in the last 20 years should alert health workers and caregivers,” 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, such as improving screening and prevention, to help control high blood pressure in children and reduce the risk of additional health complications later in life.”
The meta-analysis reviewed data from 96 studies including more than 443,000 children in 21 countries.The researchers investigated that the way blood pressure is measured in children and adolescents can influence prevalence estimates, which range from 4.3% when high blood pressure is confirmed in at least three in-person consultations, to 6.7% if assessments outside the consultation are included.
The research highlights, for example, that masked hypertension, in which high blood pressure goes undetected during routine checkups, affects approximately 9.2% of children and adolescents worldwide, suggesting possible underdiagnosis. Also the spread White coat hypertension (a condition in which a person’s blood pressure increases only in a medical setting, such as a doctor’s office, but is normal at home or when measured with a home blood pressure monitor) by 5.2%, indicating that a large percentage of children may be misdiagnosed.
Misdiagnosis
“Childhood hypertension is more common than previously thought, and relying solely on traditional office blood pressure measurements is likely to underestimate the true prevalence or lead to misdiagnosis of high blood pressure in children and adolescents.” Early detection and improved access to prevention and treatment options are more important than ever to identify children who have high blood pressure or are at risk of developing it. “Treating high blood pressure in children is vital to prevent future health complications during the transition to adulthood,” says Paige Song, MD, study author and professor at Zhejiang University School of Medicine in China.
The report indicates that children and adolescents who suffer from obesity have an eight-fold increased risk of developing high blood pressure. Approximately 19% of obese children suffer from it, compared to 2.4% of healthy weight children and adolescents.
The study also indicates that an additional 8.2% of children and teens have prehypertension, meaning their blood pressure levels are higher than normal but do not yet meet the criteria for a diagnosis of high blood pressure. High blood pressure is particularly common during adolescence, with rates reaching about 11.8% among adolescents, compared with about 7% in younger children.
Blood pressure levels also tend to rise sharply in early adolescence, reaching a peak around age 14, especially among boys. This pattern underscores the importance of regular blood pressure checks during these crucial years. Children and teenagers with pre-hypertension are more likely to develop high blood pressure.
In a related comment, lead author Rahul Chanchlani of McMaster University in Canada, who was not involved in the study, says: “The challenge is clear: ensuring that no case of high blood pressure in children goes undetected, unrecognized or untreated.”
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