The worldwide prevalence of high blood pressure in children and adolescents nearly doubled between 2000 and 2020, new research shows, with obesity potentially driving the increase.
In 2000, about 3.2% of children had hypertension. By 2020, the prevalence had increased to more than 6.2% of children and adolescents under age 19, affecting 114 million young people around the world, according to a report in The Lancet Child & Adolescent Health.
The study also found that an additional 8.2% of children and adolescents have blood pressure levels higher than normal but do not yet meet the criteria for hypertension.
Obesity may be a substantial driver of the increase in childhood hypertension, the data suggest.
Nearly 19% of children and adolescents living with obesity were hypertensive, compared to less than 3% of children and adolescents considered to be at a healthy weight.
Obesity can cause other health problems, such as insulin resistance and changes in blood vessels, which make it harder to keep blood pressure within a healthy range, the authors noted.
Reviewing data from 96 studies involving more than 443,000 children in 21 countries, the researchers found that how blood pressure is measured in children and adolescents can affect prevalence estimates.
When hypertension is confirmed by a healthcare provider over at least three in-office visits, the prevalence was estimated to be about 4.3%.
However, when out-of-office assessments such as home blood pressure monitoring were included, the prevalence of sustained hypertension climbed to about 6.7%.
The research highlighted that conditions like masked hypertension, in which the condition is not detected during routine checkups, affect nearly 9.2% of children and adolescents globally, indicating potential underdiagnosis.
Conversely, the prevalence of white-coat hypertension – that is, when blood pressure is elevated only in the presence of a healthcare provider but is normal at home - was estimated at 5.2%, which suggests that a notable proportion of children might be misclassified, the researchers said.