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Paediatric hypertension as a life-course public health challenge

Pediatric Research (2026)Cite this article

Recent global analyses show that hypertension in children and adolescents is more common than previously assumed and has increased steadily over the past two decades. Updated prevalence estimates suggest that between 4% and 7% of the paediatric population meets diagnostic criteria for hypertension, with higher rates observed when repeated or out-of-office blood pressure measurements are used.1,2,3 These findings raise concern about the early emergence of a condition long regarded as predominantly adult.

Childhood hypertension reflects a combination of biological vulnerability and early-life exposures that accumulate across development. Excess adiposity remains a central risk factor, but recent work highlights the additional roles of asthma, systemic inflammation, poor sleep, physical inactivity, high sodium intake, and adverse perinatal conditions.3,4 These factors are unevenly distributed across populations and tend to cluster in socioeconomically disadvantaged contexts, suggesting that childhood hypertension develops within broader patterns of social and environmental inequality.

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References

  1. Zhou, J. et al. Global prevalence of hypertension among children and adolescents aged 19 years or younger: an updated systematic review and meta-analysis. Lancet Child Adolesc. Health 10, 11–21, https://doi.org/10.1016/S2352-4642(25)00302-5 (2026).

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  2. Song, P. et al. Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr. 173, 1154–1163, https://doi.org/10.1001/jamapediatrics.2019.3310 (2019).

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  3. Fujiwara, T. et al. Hypertension in children and adolescents: emerging global evidence and clinical implications. Hypertens. Res. https://doi.org/10.1038/s41440-025-02459-7 (2025).

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  4. Chanchlani, R., Brady, T., Kruger, R. & Sinha, M. D. (2025). Under pressure: the lifelong cardiovascular health of children and youth with primary hypertension. Lancet Child Adolesc Health S2352-4642(25)00302-5. Advance online publication https://doi.org/10.1016/S2352-4642(25)00302-5 (2025).

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Authors and Affiliations

  1. Universidade do Extremo Sul Catarinense, UNESC, Criciúma, Santa Catarina, Brazil

    Luana Stangherlin dos Santos & Júlio César Claudino dos Santos

  2. Universidade Federal Fluminense, UFF, Niterói, Rio de Janeiro, Brazil

    Júlio César Claudino dos Santos

  3. Instituto de Neurociência do Espírito Santo, Vitória, ES, Brazil

    Marcelo Masruha Rodrigues

Authors
  1. Luana Stangherlin dos Santos
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  2. Júlio César Claudino dos Santos
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  3. Marcelo Masruha Rodrigues
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Contributions

L.S.S., J.C.C.S., and M.M.R. jointly conceived the idea for the manuscript. L.S.S. conducted the literature review and drafted the initial version. J.C.C.S. and M.M.R. contributed to the critical revision of the content, contextual analysis, and final approval of the manuscript. Both authors meet the criteria for authorship and take full responsibility for the content.

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Correspondence to Júlio César Claudino dos Santos.

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dos Santos, L.S., dos Santos, J.C.C. & Rodrigues, M.M. Paediatric hypertension as a life-course public health challenge. Pediatr Res (2026). https://doi.org/10.1038/s41390-026-04829-4

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