Childhood obesity is a major factor behind the worldwide surge in hypertension among children and adolescents between 2000 and 2020.
- The number of children with high blood pressure worldwide has almost doubled between 2000 and 2020
- Obesity increases hypertension risk in children nearly eight times compared to healthy-weight peers
- Early screening and prevention are key to protecting future generations from cardiovascular diseases
The worldwide proportion of children and adolescents with high blood pressure nearly doubled between 2000 and 2020, according to a meta-analysis published in The Lancet Child & Adolescent Health journal (1✔ ✔Trusted Source
Global prevalence of hypertension among children and adolescents aged 19 years or younger: an updated systematic review and meta-analysis
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In 2000, about 3.2% of children were found to have hypertension, but by 2020, this figure had risen to more than 6.2% among those under the age of 19, affecting around 114 million young people across the globe.
The findings indicate that obesity is a major contributing factor to the growing rates of childhood hypertension, with nearly 19% of children and adolescents living with obesity experiencing hypertension, compared with less than 3% among those with a healthy weight.
“The nearly twofold rise in high blood pressure among children over the past 20 years should serve as a serious warning for healthcare professionals and caregivers,” stated study author Prof Igor Rudan, Director of the Centre for Global Health Research at The Usher Institute, University of Edinburgh (UK). “However, the encouraging aspect is that we can take immediate measures, such as improving screening and preventive programs, to help manage high blood pressure in children and lower the likelihood of future health issues.”
Variation in Childhood Hypertension Based on Assessment Type
Drawing on a meta-analysis of data from 96 extensive studies involving more than 443,000 children from 21 countries, researchers discovered that methods used to measure blood pressure in children and adolescents can significantly affect prevalence estimates.
When hypertension was confirmed by healthcare professionals during at least three office visits, the estimated prevalence was around 4.3%. However, when additional assessments, such as home or ambulatory blood pressure monitoring, were included, the prevalence of sustained hypertension rose to approximately 6.7%.
The study also revealed that masked hypertension, where high blood pressure is not detected during routine medical visits impacts about 9.2% of children and adolescents worldwide, indicating that many cases may go undiagnosed.
At the same time, the prevalence of white-coat hypertension (a condition where blood pressure is high only in clinical settings but normal at home) was estimated at 5.2%, suggesting that many children might be incorrectly classified.
“High blood pressure in children is more widespread than previously recognized, and depending solely on traditional office-based readings tends to underestimate the true prevalence or cause misdiagnosis of hypertension among children and adolescents. Early identification and enhanced access to preventive and treatment strategies are now more important than ever to detect those who have or are at risk of hypertension. Tackling childhood hypertension promptly is key to avoiding health complications as these children move into adulthood,” said study author Dr. Peige Song of the Zhejiang University School of Medicine (China).
Link Between Obesity and Childhood Hypertension
The analysis found that children and adolescents with obesity are almost eight times more likely to develop high blood pressure, with approximately 19% of those living with obesity diagnosed with hypertension, compared to 2.4% among those within a healthy weight range.
This connection arises because obesity can trigger other health concerns such as insulin resistance and changes in blood vessel function, making it more difficult to maintain normal blood pressure levels.
The study also indicates that another 8.2% of children and adolescents fall under the category of prehypertension, meaning their blood pressure is above normal but does not yet meet the threshold for hypertension. Prehypertension is particularly common in adolescence, with rates reaching about 11.8% among teenagers compared with roughly 7% among younger children.
Blood pressure levels also tend to rise sharply during early adolescence, peaking around age 14, especially in boys. This pattern shows the need for consistent blood pressure screening during these vital developmental years. Children and adolescents with prehypertension face a greater likelihood of progressing to full hypertension.
Barriers to Accurate Assessment of Childhood Hypertension
The authors noted several limitations, including data variation resulting from differences in measurement techniques, study methodologies, and regional healthcare systems. A significant portion of the included research originated from low- and middle-income countries, which could influence how globally representative the findings are.
Moreover, certain hypertension subtypes and out-of-office measurement data were limited. Additionally, practical obstacles such as limited access to advanced monitoring devices in some regions may hinder the widespread use of recommended diagnostic methods.
In a linked Comment, lead author Rahul Chanchlani of McMaster University (Canada), who was not part of the research, remarked, “Standardized diagnostic criteria, wider use of out-of-office monitoring, and context-sensitive surveillance are essential next steps. Educating healthcare providers, families, and policymakers is equally vital.
Integrating and implementing childhood hypertension into broader non-communicable disease prevention initiatives should be a key focus, acknowledging that cardiovascular risk starts in childhood, not middle age. The challenge ahead is clear: to ensure that every child with elevated blood pressure is identified, acknowledged, and treated.”
In conclusion, the sharp rise in childhood and adolescent hypertension over the past two decades highlights an urgent public health challenge. With obesity identified as a key contributor, early detection, regular screening, and preventive strategies are vital to safeguard the health of young people.
Reference:
- Global prevalence of hypertension among children and adolescents aged 19 years or younger: an updated systematic review and meta-analysis – (https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(25)00281-0/abstract)
Source-Medindia