Childhood Hypertension Linked to Increased Risk of Early Heart Disease Death

Recent research presented at the American Heart Association's Hypertension Scientific Sessions 2025 has highlighted concerning links between childhood hypertension and the risk of premature cardiovascular mortality. The study suggests that children with elevated blood pressure at the age of seven may face a significantly higher risk of dying from heart disease by their mid-50s.

The analysis, published simultaneously in JAMA, revealed that children diagnosed with hypertension or elevated blood pressure could experience a 40% to 50% increased risk of cardiovascular mortality over the subsequent decades. This information underscores the critical need for regular blood pressure screenings in childhood to promote lifelong cardiovascular health.

Lead researcher, Alexa Freedman, Ph.D., emphasized the importance of early detection, noting the surprising link between childhood blood pressure levels and serious health outcomes many years later. Previous studies have established a connection between childhood blood pressure and cardiovascular disease risk in adulthood, with one study indicating that elevated blood pressure in older children increased the likelihood of cardiovascular death by middle age.

This new investigation stands out as the first to assess both systolic and diastolic blood pressure in a diverse cohort of children and its long-term implications for cardiovascular mortality. The American Academy of Pediatrics recommends annual blood pressure checks starting at age three, aligning with the findings of this study.

Dr. Bonita Falkner, an expert with the American Heart Association, affirmed the significance of monitoring blood pressure during childhood. The study adds to the growing body of evidence that highlights the need to accurately define abnormal blood pressure and hypertension in younger populations.

The research utilized data from the National Death Index to track the health outcomes of nearly 38,000 children who had their blood pressure measured at age seven as part of the Collaborative Perinatal Project, a major study examining the health impacts of pregnancy and early life factors.

Blood pressure readings were analyzed and adjusted for demographic factors, childhood body mass index, and other relevant variables to isolate the effects of blood pressure itself. The findings indicated that those with higher blood pressure at age seven had an increased likelihood of dying from cardiovascular disease by their mid-50s, with the highest risk observed among those in the top 10% for age, sex, and height.

Out of the participants, 2,837 deaths were recorded by 2016, with 504 attributed to cardiovascular disease. Notably, both elevated blood pressure and hypertension were linked to a significant increase in the risk of early cardiovascular death, with moderate elevations in blood pressure also posing risks, even among children within normal ranges.

Furthermore, the analysis of sibling clusters indicated that higher blood pressure readings were associated with increased cardiovascular death risk, suggesting that familial and environmental factors alone could not fully explain the findings.

Freedman pointed out the profound implications of these results, urging parents to monitor their children's blood pressure proactively. The research does have limitations, including the reliance on a single blood pressure measurement and the demographic homogeneity of the original participants, which may not reflect the broader population.

In conclusion, the study's findings support the necessity of regular blood pressure monitoring among children, reinforcing the need for early intervention strategies to mitigate long-term cardiovascular risks.