There is a surge in the number of children suffering from hypertension in the world. According to a new analysis published in the journal ‘The Lancet Child & Adolescent Health’, the percentage of children under 19 years with high blood pressure the figure almost doubled between 2000 and 2020, reaching 114 million young people suffering from the disease. If in 2000 hypertension sufferers in children and adolescents were around 3.2%, then in 2020 the prevalence will increase to above 6.2%.. The study shows thatObesity is one of the determining factors in this increase in childhood hypertension: nearly 19% of large children and adolescents have hypertension, compared with less than 3% recorded in the weight range considered normal.
Study room
“The almost doubling of hypertension in children over 20 years should be a wake-up call for health professionals and those caring for children,” commented 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 increasing screening and prevention efforts, to help control hypertension in children and reduce the risk of further health complications in the future.”
The authors conducted a meta-analysis of data from 96 large studies involving more than 443,000 children in 21 countries, and found that the way blood pressure is measured in people under 19 can influence prevalence estimates. When hypertension was confirmed by a healthcare provider in at least 3 visits, the prevalence was estimated to be approximately 4.3%, but when researchers also included assessments such as ambulatory or home blood pressure monitoring, the prevalence of ongoing hypertension increased to approximately 6.7%.
The study also highlights situations such as masked hypertension – when high blood pressure is not detected during routine check-ups – which affects nearly 9.2% of children and adolescents worldwide, indicating potential underdiagnosis. At the same time, the prevalence of so-called ‘white coat hypertension’ (a condition in which a person’s blood pressure rises only when in a medical setting, but is normal at home) has increased.nanny estimates were 5.2%, indicating that a large proportion of children may have been misclassified.
In any case, notes author Peige Song, of Zhejiang University School of Medicine (China), “childhood hypertension is more common than previously thought and relying solely on traditional office blood pressure measurements may underestimate the true prevalence or lead to misdiagnosis.” Instead, it is vital that the diagnosis arrives and is carried out early, he continued. Along with “better access to prevention and treatment options, they are becoming more important factors in identifying children who have hypertension or are at risk of developing hypertension. Addressing these issues now is critical to preventing future health complications as they transition into adulthood.”
Risks associated with obesity
Analysis shows that children and adolescents with obesity have an almost 8 times greater risk of developing hypertensionand this – the authors explain – occurs because obesity can lead to other health problems, such as insulin resistance and vascular changes, which make it difficult to maintain blood pressure in a healthy range. Finally, research shows that 8.2% of children and adolescents suffer from pre-hypertension, that is, blood pressure levels are higher than normal, but not yet within the values considered to be hypertension.
This condition is very common in adolescence, with an incidence of around 11.8% among teenagers, compared with around 7% in younger children. Blood pressure levels tend to rise sharply during early adolescence, and peak around age 14, especially among boys. This trend highlights the importance of regular check-ups during critical years, experts say, because those with pre-hypertension are more likely to develop severe hypertension.
The authors acknowledge several study limitations, including data variability related to differences in measurement methods or the fact that most of the studies analyzed come from low- and middle-income countries, which may influence the overall applicability of the estimates globally. “Harmonized diagnostic criteria, expanded off-site monitoring, and contextual surveillance are important next steps,” lead author Rahul Chanchlani of McMaster University (Canada), who was not involved in the study, wrote in a related commentary. “Education of health workers, families and policymakers is also key.
Integrating childhood hypertension into broader non-communicable disease prevention strategies is a priority, given that cardiovascular risk does not begin in middle age, but in childhood. The task ahead is simple: ensure that no case of high blood pressure goes unnoticed, unrecognized or untreated.”
