The rate of children and teenagers living with high blood pressure globally has almost doubled in two decades, according to the largest review of its kind. The prevalence of high blood pressure in those under 19 has increased from three per cent in 2000 to more than six per cent in 2020, affecting 114 million young people worldwide.Obesity is a substantial driver of the rise, with nearly a fifth of children and teens living with obesity affected by high blood pressure. This is eight times higher than children and teens considered a healthy weight, experts say.Researchers stress that addressing high blood pressure – also known as hypertension – in childhood is vital to prevent future health complications, such as heart disease and kidney disease, as children transition to adulthood.Early signsThe research team, led by The University of Edinburgh and Zhejiang University School of Medicine in China, analysed data from 96 studies involving more than 443,000 children across 21 countries.An additional eight per cent of children and teenagers now have prehypertension, a warning sign of potential progression to hypertension, with rates reaching nearly 12 per cent among teenagers. Researchers say blood pressure levels rise sharply in early adolescence, peaking about the age of 14, especially among boys. This underlines the critical importance of regular screening during these critical years, they add. The nearly twofold increase in childhood high blood pressure over 20 years should raise alarm bells for healthcare providers and caregivers. 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. Professor Igor Rudan Professor of International Health and Molecular Medicine and Co-Head of Centre for Global Health, Usher Institute Hidden conditionHow blood pressure is measured in children and adolescents can also affect prevalence estimates. When hypertension is confirmed by a healthcare provider over at least three in-office visits, the prevalence was estimated to be around four per cent. When researchers also included out-of-office assessments, such as home blood pressure monitoring, this jumped to nearly seven per cent.The research highlights that conditions like masked hypertension – where high blood pressure is not detected during routine check-ups – could contribute to potential underdiagnosis.Early detection and improved access to prevention and treatment options are more critical than ever to tackle the rising tide of childhood hypertension globally, experts say. 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. Dr Peige Song Zhejiang University School of Medicine The study was funded by the National Natural Science Foundation of China. Further informationRead the paper in The Lancet Child and Adolescent Health Publication date 14 Nov, 2025
