Childhood hypertension is becoming more common than previously thought, with a 4% prevalence rate worldwide. This represents a considerable public health challenge, reported the authors of a study published in JAMA Pediatrics.

“From the public health perspective, reliable estimates of the prevalence of childhood hypertension serve as the basis for adequate prevention and treatment, as well as evidence-based health resource allocation and policy making,” stated Peige Song, PhD, of The George Institute for Global Health, University of Oxford, and colleagues.

The UK researchers conducted a systematic review and meta-analysis of literature using search terms related to hypertension, children, and prevalence. Studies included in the study had a sample of children or adolescents ≤19 years old and provided numeric prevalence estimates of hypertension (defined as a systolic blood pressure [BP] or a diastolic BP greater than or equal to the 95th percentile by sex, age, and height), prehypertension, stage 1 hypertension, stage 2 hypertension, or different phenotypes of hypertension. Included studies also had BP measurements from at least 3 separate occasions.

A total of 47 articles were included in the study; 32 of 47 (68%) were published from 2010 onward, and 22 (47%) were conducted in urban-rural mixed settings. A total of 29 (62%) reported the prevalence data for both boys and girls and 28 (60%) had a sample size >2000 patients. The most commonly used device for measuring BP found in the articles was mercury sphygmomanometer (19), followed by oscillometric sphygmomanometer (16).

The pooled prevalence was 4.0% for hypertension, 9.67% for prehypertension, 4.0% for stage 1 hypertension, and 0.95% for stage 2 hypertension in children. The prevalence of hypertension was higher when measured by aneroid sphygmomanometer (7.23%) compared with mercury sphygmomanometer (4.59%) and oscillometric sphygmomanometer (2.94%). Hypertension was also more common among obese (15.27%) and overweight children (4.99%) compared with normal-weight children (1.90%).  

An increasing prevalence of childhood hypertension was found during the past 2 decades with a relative increasing rate of 75% to 79% identified from 2000 to 2015. The prevalence of hypertension in 2015 ranged from 4.32% among children aged 6 years to 3.28% among those aged 19 years; the prevalence peaked at 7.89% among children aged 14 years.

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“Childhood hypertension was generally more common in adolescents undergoing puberty and children who were overweight or obese,” the authors concluded. “An upward trend of hypertension prevalence in children during the past 2 decades was observed and may persist in the future.”

Reference

Song P, Zhang Y, Yu J, et al. Global prevalence of hypertension in children: a systematic review and meta-analysis [published online October 7, 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.3310.