Daijiworld Media Network - London

London, Feb 13: Hypertension among children and adolescents is no longer a rare condition but an escalating global health concern that demands urgent attention to prevent long-term heart, blood vessel and kidney disease, an expert panel has cautioned.

The warning comes in a new position paper issued by the International Society of Hypertension and published in the Journal of Hypertension.

Dr Joseph Flynn, professor of pediatrics at the University of Washington School of Medicine and a clinician at Seattle Children's Hospital, said early and accurate detection is crucial.

“One of the most important messages of this paper is that accurate measurement and early detection really matter, because when hypertension is identified early, many young people can be treated to prevent future heart and kidney problems,” he noted.
Co-author Ruan Kruger, a professor and hypertension specialist at North-West University in South Africa, warned that the risks are already visible in young patients.

“We are not just talking about a future risk. In many cases, children with hypertension already show early organ damage, such as thickening of the heart muscle, which is linked to a higher risk of heart disease in adulthood. The adverse effects of hypertension usually seen in middle age are now being detected in children and young people,” he said.

According to the report, the prevalence of hypertension among children under 19 doubled from 2000 to 2020, reaching 6%. It now affects an estimated 114 million children and teenagers worldwide. The burden is higher in low- and middle-income countries, particularly in sub-Saharan Africa and South Asia.

The panel attributed the rise to a complex interplay of factors including childhood obesity, sedentary lifestyles, unhealthy diets, chronic stress, sleep disruption, and adverse childhood experiences such as neglect and abuse.

The paper recommends a flexible global framework for detection and treatment that countries can adapt based on available resources. The panel observed that many existing guidelines are not suited to low-resource settings, limiting their practical implementation.

Experts stressed that regular screening for high blood pressure is essential, especially for children at greater risk due to premature birth, heart, kidney or urologic diseases, diabetes or obesity. Blood pressure checks must follow recommended protocols and use devices validated for children to ensure accurate readings.

Lifestyle modification should be the first line of management. The panel advised a reduced-sodium diet rich in fruits, vegetables, whole grains, lean meats and low-fat dairy, along with at least 60 minutes of moderate-to-vigorous physical activity daily. Stress reduction through mindfulness and yoga, maintaining healthy weight, and family involvement in adopting healthy habits were also emphasised.

For children with mild hypertension and no co-morbid conditions such as kidney disease or diabetes, lifestyle changes should be attempted for six months before initiating medication. However, children with symptoms, severe hypertension, or additional medical conditions should begin drug therapy immediately. Long-term follow-up into adulthood is critical to prevent complications.

The panel concluded that reversing the trend will require coordinated public health strategies and sustained policy support, underscoring the need for a unified global commitment to address hypertension in the young.