High blood pressure is a common health problem among middle-aged and older adults, but new research shows that this silent killer is now impacting the lives of America’s children at an alarming rate. Recent studies have shown that children as young as eight already have high blood pressure and a significant proportion are on the verge of developing it.
These findings come from two studies presented at the 2024 American Heart Association Hypertension Scientific Sessions held in early September. Although both studies are preliminary research abstracts and have not yet been peer-reviewed and published, they highlight the urgent need for greater prevention efforts and policies targeting youth so they can implement lifestyle changes earlier.
High blood pressure in adolescents is associated with social factors
Both studies used data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. first study1 Finding that 23% of young people aged 18 to 39 already suffer from high blood pressure, they analyzed how social needs, defined as social determinants of health, may play a role in the development of this condition.
These include “low levels of education, low income, no health insurance, food insecurity, and no or limited employment.” According to a press release from the AHA:2
“The authors defined low education as a high school degree or less, low income as a household income below 100% of the federal poverty level, and food insecurity as low or very low household food security in the past 12 months. Not looking for work or not working. Employment limited to certain cases — excludes those who are retired or attending school.”
The researchers found that younger people with high blood pressure were more likely than older people to be uninsured, belong to low-income households, and lack food security.3
However, these social factors are not only associated with high blood pressure. It also actively interferes with management. Adults with high blood pressure and two or more social needs are about 80% more likely to not receive treatment and 70% more likely to have uncontrolled high blood pressure than adults with no social needs.
However, the researchers acknowledge that because their study is not a randomized controlled trial (meaning it does not determine exact cause and effect), the study only suggests an association. Dr. Thomas Alexander, one of the study authors and an MD candidate at the Feinberg School of Medicine at Northwestern University in Chicago, said:
“Social determinants of health are the social conditions that arise where people are born, live, learn, work, and mature. Young adults with social needs and high blood pressure need more support to reach their blood pressure goals.
“Our study highlights that addressing these social determinants through targeted public health strategies is essential to improve outcomes and prevent long-term heart disease and stroke complications in vulnerable populations.”4
School-age children and adolescents also suffer from high blood pressure
In the second study5 Researchers looked at rates of high blood pressure in younger age groups, including elementary school students and teenagers. They examined blood pressure and body mass index (BMI) data from 2,600 children ages 8 to 19 and found that 8.7% had high blood pressure and 5.4% had high blood pressure.6
Researchers evaluated data based on children’s gender, ethnicity, and BMI to see how these factors affected their risk of high blood pressure. They found that boys were more likely than girls to have higher blood pressure levels, and that these levels increased with age. Hispanic children had the lowest prevalence of elevated blood pressure, and severely obese children had the highest prevalence.7
Age also affects blood pressure trends in adolescents. The study found that the rate of rise in blood pressure increases with age. In the 8-12 age group, only 3.3% had elevated blood pressure, while in the 18-19 age group, this rate jumped to 16.7%.
Dr. Ahlia Sekkarie, an epidemiologist in the Division of Heart Disease and Stroke Prevention at the U.S. Centers for Disease Control and Prevention and lead author of the second study, said:
“Hypertension can start in childhood and is a risk factor for heart disease and stroke. It is important to monitor blood pressure during adolescence because young people with risk factors for heart disease and stroke are more likely to develop cardiovascular disease as adults. “This is a great time to learn healthy habits to reduce these risks.”8
Sekkarie notes that childhood obesity, a condition that is also linked to cardiovascular disease (CVD), plays a role in the development of high blood pressure. She also notes that many teens are “conflicted.” As you transition out of pediatrics, you may not be seeing your primary care physician regularly, which means you’ll be missing out on routine checkups.9
Pediatric Hypertension Is Associated with Cardiovascular Disease Later in Life
The CDC says heart disease is now the leading cause of death in the United States, with one person dying from the disease every 33 seconds.10 High blood pressure is one of the risk factors for heart disease and needs urgent attention as the rate is increasing in young people.
If blood pressure is uncontrolled, the load on the heart muscle increases. This can lead to heart failure and damage the arteries that supply oxygen to the muscles, putting you at risk for a heart attack. Small arteries may also become damaged, causing harm to other organs such as the kidneys or eyes.11
In an AHA press release, Elaine Urbina, director of preventive cardiology at the Heart Institute at Cincinnati Children’s Hospital in Ohio, noted that many families and primary care providers don’t realize that high blood pressure can begin in childhood, especially adolescence, and can be linked to poor lifestyle habits. Overweight and obesity are risk factors.12
“We need to address high blood pressure rates or we will have people suffering heart attacks and strokes at a young age.” she comments.13
In 2023, Urbina and researchers wrote a study published in the journal Hypertension.14 Regarding primary hypertension in adolescents, they found that young people who developed primary hypertension in childhood or adolescence tended to maintain that level into adulthood, putting them at increased risk for cardiovascular disease.
The study also highlighted other risk factors associated with childhood hypertension, including sleep, suboptimal eating habits, physical fitness and environmental stress, in addition to obesity.
“In addition to primary prevention, regular clinical blood pressure monitoring of all pediatric patients using standard measurement protocols is recommended to identify children with elevated blood pressure and hypertension. Adolescents entering adulthood with blood pressure less than 120/80 mmHg are the optimal targets. no see.” They concluded:15
Make healthy changes to your child’s diet
As noted in the featured study, being overweight or obese is one of the significant factors that puts children at risk for high blood pressure. According to the CDC, 14.7 million children ages 2 to 19 in the United States are currently considered obese. This represents 19.7%, or one-fifth, of all children in the United States.16
One of the main causes is the excessive consumption of ultra-processed and junk foods that are prevalent in today’s modern diet. When children continue to consume these ultra-processed foods, they not only consume “empty calories” that cause weight gain, but they also begin a cascade of fatal health declines rooted in mitochondrial dysfunction and insulin resistance.
The main reason is that ultra-processed foods contain seed oils, which contain linoleic acid (LA). These polyunsaturated fats (PUFA) are the most harmful ingredients in the modern diet and are even worse than sugar.
LA is an important cause of all diseases, including obesity. Therefore, eliminating all sources of seed oil from your child’s diet, or limiting it to 5 grams (or better, 2 grams) per day, is an important strategy for minimizing the risk of obesity and high blood pressure.
Consuming a lot of processed foods containing processed table salt can cause your child’s sodium-to-potassium ratio to become unbalanced, which is a significant cause of high blood pressure.
Contrary to popular belief, a restrictive, low-salt diet is not the key to solving high blood pressure. Reducing salt intake worsens the total cholesterol to high-density lipoprotein (HDL) ratio. That means, instead, it increases your risk of heart disease. Salt deficiency also increases the likelihood of developing insulin resistance because one of the body’s ways of conserving salt is by increasing insulin levels.
Rather, you’ll want to optimize your sodium to potassium ratio. Potassium helps your body relax artery walls, prevents muscle spasms, and lowers blood pressure. To do this, make sure you and your children eat whole, unprocessed foods, ideally locally and organically grown, for optimal nutrient content. This type of diet naturally provides much higher amounts of potassium compared to sodium.
As the AHA notes, “Foods containing potassium may help regulate blood pressure by blunting the effects of sodium. The more potassium you eat, the more sodium you flush out of your body.”17
Lack of sleep has also been linked to high blood pressure in children
Assessing your child’s bedtime habits is also important in managing blood pressure. A June 2024 study published in the journal Pediatrics found that18 Researchers found that children who don’t get enough sleep on a regular basis have a higher risk of developing high blood pressure.
The sample included 539 children and adolescents aged 4 to 22 years, with a mean age of 14.6 years. Of these patients, 56% met criteria for hypertension. Study participants wore blood pressure monitoring devices that continuously measured their blood pressure 24/7 in addition to recording their sleeping and waking times.19
Researchers found that the average sleep time was 9.1 hours. Depending on age, this is 1 to 4 hours less than recommended. They also found an association between longer sleep duration during the day and better blood pressure parameters. Meanwhile, sleeping later was associated with worse daytime blood pressure indices.20
“Longer sleep duration and earlier sleep onset are associated with lower blood pressure, suggesting that sleep optimization may be an important target for hypertension management interventions.” They concluded:21
According to Dr. Amy Kogon, an assistant professor at the Perelman School of Medicine at the University of Pennsylvania and lead author of the study, as many as one-third of elementary school children are not getting the recommended amount of sleep. Additionally, most doctors do not provide sufficient guidance on sleep when counseling parents about high blood pressure.
“We usually target things like diet and exercise. This is another thing parents might want to think about, especially if their child has high blood pressure,” she said.22
One of the best strategies to help optimize your child’s sleep is to reduce device use, especially during bedtime. A recent experiment conducted on 10 teenagers found that one of the biggest benefits of stopping smartphone use for a month was a noticeable improvement in sleep. Teens experienced longer sleep duration and improved sleep quality during the detox period.
But there are other useful techniques that can help you optimize your child’s sleep. For detailed guidance, please read my article “Top 33 Tips to Optimize Your Sleep Routine.”
