Hypertension cases among children, teens doubled in 2 decades: Study

Prevalence of hypertension or high blood pressure among children and teenagers has nearly doubled in the last two decades, from 3.2 per cent in 2000 to over six per cent in 2020, according to a global analysis published in The Lancet Child and Adolescent Health journal.

Left unaddressed, hypertension can lead to cardiovascular and kidney disease.

Estimates also suggest that nearly a fifth of the world's children and adolescents with obesity have hypertension -- about eight times the prevalence among those having a healthy weight (2.4 per cent), researchers including those from the UK's University of Edinburgh said.

The findings suggest obesity is a substantial driver of the increase in childhood hypertension. Obesity tends to cause other issues, such as insulin resistance and changes in blood vessels, which can make it harder to maintain a healthy blood pressure.

Further, eight per cent of children and teenagers around the world may be having pre-hypertension, which is a warning sign of hypertension, the study found.

"The nearly twofold increase in childhood high blood pressure over 20 years should raise alarm bells for healthcare providers and caregivers," said study author Igor Rudan, director of the centre for global health research at The Usher Institute, University of Edinburgh (UK).

"But the good news is that we can take steps now, such as improving screening and prevention efforts, to help control high blood pressure in children and reduce the risks of additional health complications in the future," Rudan said.

The meta-analysis looked at data from 96 previously published studies, involving more than 443,000 children and across 21 countries.

"Between 2000 and 2020, the prevalence of childhood hypertension nearly doubled, increasing from 3.40 per cent to 6.53 per cent in boys and from 3.02 per cent to 5.82 per cent in girls," the authors wrote.

The study also found that more than nine per cent of children and adolescents the world over may have masked hypertension -- which is high blood pressure that only shows up in out-of-office tests and therefore could be undetected during regular checkups.

How blood pressure is measured can affect prevalence estimates, the researchers said.

For example, when confirmed by a healthcare provider at a minimum of three in-office visits, the global prevalence of hypertension was estimated at 4.3 per cent of children and adolescents.

However, when the researchers also included out-of-office assessments such as home blood pressure monitoring, the prevalence of sustained hypertension climbed to about 6.7 per cent.

"Childhood high blood pressure is more common than previously thought, and relying solely on traditional in-office blood pressure readings likely underestimates the true prevalence or leads to misdiagnosis of hypertension in children and adolescents," said study author Peige Song of the Zhejiang University School of Medicine in China.

"Early detection and (an) improved access to prevention and treatment options are more critical than ever to identify children experiencing or at-risk for hypertension. Addressing childhood hypertension now is vital to prevent future health complications as children transition to adulthood," Song said.

Pre-hypertension is especially prevalent during teenage, with prevalence reaching around 11.8 per cent, compared to about seven per cent in younger children, the researchers found.

Blood pressure also tends to increase sharply during early adolescence, peaking around age 14, especially among boys, they said.

The pattern emphasises the importance of regular blood pressure screening during critical years, the team added.