Childhood hypertension has doubled globally in 20 years, Lancet warns

A Lancet review of global data shows childhood hypertension has doubled in 20 years, driven by rising obesity, inactivity and poor sleep, raising urgent concerns for parents and schools

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Cases of high blood pressure among children and teenagers have nearly doubled worldwide in the past 20 years, new research shows.

 

The findings come from the study Global prevalence of hypertension among children and adolescents aged 19 years or younger: an updated systematic review and meta-analysis, published in The Lancet Child & Adolescent Health, which analysed data from 96 studies across 21 countries involving more than 443,000 young people.

 

The analysis shows that hypertension among under-19s rose from around 3.2 per cent in 2000 to more than 6 per cent in 2020. Boys saw an increase from roughly 3.40 per cent to 6.53 per cent, and girls from 3.02 per cent to 5.82 per cent. 

The study also identified a worrying rise in “pre-hypertension” affecting about 8 per cent of children and teens and “masked hypertension”, which may affect more than 9 per cent of young people and is often missed during routine clinic visits.

 

Researchers noted that the use of home or ambulatory blood-pressure monitoring pushed prevalence numbers even higher, suggesting standard clinic readings are not capturing the full scope of the problem.

 

Why is hypertension in children a serious concern?

 

According to doctors, high blood pressure in childhood acts like an early warning siren for future illness. If not identified and managed, it can lead to cardiovascular disease, kidney disease, and other long-term complications as these children grow into adults. The study’s authors stress that hypertension detected early in life has a strong tendency to persist, making prevention and timely intervention essential.

 

What is driving this rise globally?

 

The study points strongly towards rising childhood obesity as a central driver. Researchers found that nearly a fifth of children and teenagers with obesity have hypertension, about eight times the rate seen in those with a healthy weight. Obesity triggers changes in blood vessels, insulin resistance, inflammatory processes, and hormonal shifts that make maintaining normal blood pressure more difficult.

 

Lifestyle factors are also at play, particularly the growing dominance of processed foods, long hours of screen time, physical inactivity, and disrupted sleep cycles, all of which influence weight, metabolism and blood-pressure regulation.

 

Specialists in India warn that the global trend is already visible in the country’s schools and homes.

 

Dr Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram, says, “The silent rise of high blood pressure among India’s children and teens is a warning we can no longer ignore. What was once an adult disease is now creeping into schools. The prevention of diabetes in children lies in awareness, routine screenings, and everyday choices. Healthy homemade meals, decreased screen time, and regular movement and exercise are pillars to not only diabetes prevention but any chronic disease in children.”

 

Dr Swati Kanodia, Consultant – Paediatric Endocrinologist, Madhukar Rainbow Children’s Hospital, describes the new findings as a global wake-up call, “These findings are deeply concerning. Nearly one in ten teenagers worldwide estimated to have high blood pressure. This rise reflects the broader shift in lifestyle patterns, sedentary habits, excessive screen time, processed food consumption, and reduced physical activity, that are reshaping children’s health trajectories.”

 

She adds that India faces a unique double burden, “In India, the situation is particularly worrisome given the dual burden of obesity and undernutrition in young populations. Many teenagers today are consuming diets rich in salt, sugar, and saturated fats while spending long hours indoors, leading to weight gain and metabolic imbalances. Elevated blood pressure at a young age significantly increases the risk of heart disease, stroke, and kidney complications later in life.”

 

According to Dr Kanodia, parents, schools, and healthcare providers must work together to prioritise preventive screening and promote heart-healthy habits from an early age.

 

How can parents, schools, and health systems respond?

 

The study, along with Indian experts, points towards a multi-layered approach:

 

• Routine screening for blood pressure starting in late childhood, especially for those at higher risk

 

• Encouraging daily physical activity, outdoor play, and reduced sedentary behaviour

 

• Rebalancing diets away from processed foods, sugary beverages, and excess salt

 

• Collaborative school-based screening and health-education initiatives

 

• Family-level habits: homemade meals, consistent sleep routines, and regular monitoring of weight and blood pressure

 

Better access to home or ambulatory blood-pressure monitoring may also help spot cases missed in clinic environments, the study has found.

 

Why does this matter for India’s future?

 

India is facing rapidly shifting nutrition and lifestyle patterns among children. As obesity becomes more common and sedentary time increases, early-life metabolic risks are rising. The doubling of childhood hypertension globally is a warning of what could soon become a major domestic health challenge.

 

Failure to act early means many of these children may develop heart disease, kidney damage, and metabolic complications far sooner than previous generations.

 

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