By Kiara Doyal, The Seattle Medium
According to a recent position paper published in the Journal of Hypertension, an estimated 114 million children and adolescents worldwide were affected by hypertension between 2000 and 2020. Although hypertension is largely associated with adults, the findings highlight a growing global health concern among children and teens.
Dr. Joseph Flynn, the study’s first co-author and a professor of pediatrics at the University of Washington School of Medicine in Seattle who also practices at Seattle Children’s Hospital, said the increase in pediatric hypertension has been driven by multiple factors that vary from patient to patient.
“Of course, a particularly sedentary lifestyle, kids not having access to safe spaces to exercise, for example. And then more consumption of processed foods and less healthy foods. All those processed foods are high in salt and calories, and then that drives other things,” said Dr. Flynn.
While hypertension affects people across racial and demographic groups, Flynn said adolescents are the most commonly affected pediatric population.
“We mostly see adolescents. Also, younger children who have been struggling with their weight may also be another group,” Dr. Flynn said. “And then there are different minority populations that have a higher incidence of blood pressure problems as well.”
In the United States, disparities are particularly concerning. According to the U.S. Office of Minority Health, Black children and teens experience disproportionately high rates of hypertension. Flynn said longstanding gaps in access to consistent health care in underserved communities have made early detection and prevention more difficult.
“The lack of access to regular care for underserved communities is a barrier to preventing hypertension early on,” said Dr. Flynn. “It is important for children to have a consistent primary care doctor where something like blood pressure can be tracked over time, and where they could return if they had a high reading. So, I think the lack of access is probably a huge factor, as well as transportation, schedules, and life.”
Beyond access to care, Flynn said one of the most common clinical mistakes is failing to measure children’s blood pressure properly or at all.
“We see that all the time, even in children who have other risk factors and then not using appropriate devices is a mistake because it does take time to really do it correctly,” said Dr. Flynn. “When patients come to see me for their blood pressure, they probably spend at least 20 minutes with the medical assistant doing blood pressure measurements. So, even though there are ways to correctly do it, people don’t follow the correct procedure.”
Hypertension is still widely viewed as an adult condition, but Flynn said that perception can delay early intervention for children. However, he emphasized that pediatric cases are not rare.
“I think it is important to point out that hypertension actually affects about 4% of children, which is not as uncommon as people think. But what a lot of the long term studies have shown is that higher blood pressure in adolescence can be lined to increased rates of heart attacks and strokes in mid and late adulthood,” said Dr. Flynn. “Adolescence is very crucial, early phases, where there is an opportunity for intervention and perhaps prevention of later cardiovascular problems.”
For Flynn, the paper’s conclusions were not surprising, given years of observing similar trends in clinical practice and research.
“No surprise to me because I am on top of this literature. So for me, this was all put together by a number of people from across the globe, and they brought in what they felt was important,” said Dr. Flynn. “And the findings to me were the things I was sort of expecting.”
To improve early detection of hypertension in adolescents, Flynn said health systems must dedicate more time to training staff to measure blood pressure accurately and build care systems that make it easier for patients to return for follow-up checks. He also stressed the role of policymakers in creating safe spaces for physical activity, noting that some patients have shared they do not always feel safe exercising in their communities.
“Big health systems have done it like Kaiser Permanente in California has really done a remarkable job in implementing strategies to improve blood pressure measurement and improve blood pressure control in adults,” said Dr. Flynn. “And then public policy, we need to look at foods that are in the supermarket and what goes into them. We need to look at creating safe spaces for exercise. I think it is really important for policymakers to encourage activity and provide people opportunities for exercise.”
Ultimately, Flynn said reversing the rise in pediatric hypertension will require coordinated action from clinicians, families and policymakers to ensure children receive early screenings and have access to healthier environments.
