Survey reveals 20-year blood pressure trends among children and teens

Children run outside in a field.

On average, blood pressure levels among children and teens have fallen or stayed the same over the past two decades, but may have slightly increased over the past several years, according to research in JAMA Network Open supported by the NHLBI. Through the National Health and Nutrition Examination Survey, physicians captured blood pressure levels from 19,273 U.S. children, ages 8-12, and teens, ages 13-17, every four years between 1999-2018.

Average blood pressure levels collected throughout the survey were in a normal range, according to the 2017 American Academy of Pediatrics Clinical Practice Guidelines. Based on these measurements, 4.6% of children had hypertension, or high blood pressure, in 2015-2018, which fell from 6.2% in 2003-2006 and from 5.2% in 1999-2002. Among teens, 3.7% had hypertension in 2015-2018, which increased from 2.5% in 2011-2014 but was lower than the 6.6% average in 1999-2002. High blood pressure levels in childhood are associated with an increased risk for hypertension and cardiovascular disease in adulthood. Within this study, blood pressure levels were about 3 to 6 mm Hg higher among children and teens who were overweight or obese, among Black teens compared to white teens, and among teen boys compared to teen girls.

The authors note identifying factors that have helped reduce hypertension in the past may drive similar progress in the future. Increasing physical activity and following a heart-healthy diet, such as Dietary Approaches to Stop Hypertension, which has helped children and teens lower blood pressure levels, were noted as examples of activities that support cardiovascular health. The authors also noted health disparity research may help identify variables that account for differences in higher blood pressure levels among Black teens, which could inform strategies to support health equity among younger populations.