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Story at-a-glance

• Recent studies show high blood pressure affects American children as young as 8, with 23% of young adults (18 to 39 years old) already having the condition
• A study of 2,600 children (8 to 19 years old) found 8.7% had elevated blood pressure and 5.4% had high blood pressure, with rates increasing with age. Obesity is also a significant factor
• High blood pressure during childhood is associated with an increased risk of cardiovascular disease in adulthood. Regular blood pressure monitoring and lifestyle changes are recommended for prevention and management
• Diet plays a crucial role in managing blood pressure. Reducing ultraprocessed foods and optimizing sodium-to-potassium ratio through whole, unprocessed foods help prevent high blood pressure in children
• Lack of sleep is linked to high blood pressure in children. A study found longer sleep duration and earlier bedtimes are associated with lower blood pressure, suggesting sleep optimization is an important intervention

High blood pressure is a health concern that middle-aged adults and the elderly usually contend with, however, new research suggests that this silent killer is now affecting the lives of American children at an alarming rate. Based on recent studies, children as young as 8 years old are already dealing with high blood pressure, while a significant percentage is on the verge of developing it.

These findings come from two studies presented at the 2024 American Heart Association Hypertension Scientific Sessions 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 Although both studies are preliminary research abstracts and have not yet been peer-reviewed and published, they highlight the urgent need for greater prevention efforts and policies targeted toward the youth so they can implement lifestyle changes earlier in life.

High Blood Pressure Among the Youth Is Linked to Social Factors

Both studies used data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES). The first study1 found that 23% of young people between the ages of 18 and 39 already have high blood pressure, and analyzed how social needs, defined as social determinants of health, could play a role in the development of this condition.

These include "low 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 having lower than a high school degree; low income as a family income less than 100% of the federal poverty level; food insecurity as having low or very low household food security in the past 12 months and no/limited employment as looking for work or not working — not including those who were retired or going to school."

The researchers found that those in the younger age group who have high blood pressure were more likely to be uninsured, come from low-income households and lack food security compared to older adults.3

But these social factors don't just correlate with high blood pressure; they also actively hinder its management. Adults with high blood pressure and two or more social needs are about 80% more likely to be untreated and 70% more likely to have uncontrolled high blood pressure compared to those without social needs.

However, the researchers acknowledge that since their study is not a randomized controlled trial — meaning it does not determine an exact cause and effect — the study only suggests an association. Thomas Alexander, B.A., one of the study authors and an MD-candidate at Northwestern University's Feinberg School of Medicine in Chicago, comments:

"Social determinants of health are the social conditions arising from where people are born, live, learn, work and mature. Young adults with social needs and high blood pressure need more support to achieve 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 this vulnerable population."4

School-Age Children and Teenagers Are Also Dealing with High Blood Pressure

In the second study,5 the researchers looked at the rates of high blood pressure in a younger age group, which involves primary school-age children and teens. They looked at the blood pressure and body mass index (BMI) data of 2,600 children ages 8 to 19 and found that 8.7% had elevated blood pressure, while 5.4% had high blood pressure.6

The researchers evaluated the data based on the children's gender, ethnicity and BMI to determine how these factors affect the risk of having high blood pressure. They found that boys were more likely to have high blood pressure levels than girls, and that the levels rose with their age. Hispanic children had the lowest rate of elevated blood pressure, while those with severe obesity had the highest prevalence.7

Age also affects the blood pressure trends among youth. The study observed that rates of elevated blood pressure increased with age. While only 3.3% of participants in the 8 to 12 age group had elevated blood pressure, this rate jumped to 16.7% for those in the 18 to 19 age group.

Dr. Ahlia Sekkarie, an epidemiologist in the division for heart disease and stroke prevention at the U.S. Centers for Disease Control and Prevention and the lead research of the second study, says:

"Hypertension can begin in childhood, and it's a risk factor for heart disease and stroke. It's important to monitor blood pressure in youth, because young people with heart disease and stroke risk factors are more likely to have cardiovascular disease as adults. Childhood is a great time to learn healthy habits to reduce these risks."8

Sekkarie notes that childhood obesity, a condition that's also linked to cardiovascular disease (CVD), plays a significant role in the development of high blood pressure. She also mentions that many teens "fall through the cracks." As they transition from pediatric care, they do not regularly visit a primary care physician, causing them to miss regular screenings.9

Pediatric High Blood Pressure Is Associated with Cardiovascular Disease Later in Life

The CDC says that heart disease is now the leading cause of death in the U.S., with one person dying every 33 seconds from this condition.10 With high blood pressure being one of the risk factors associated with heart disease, the increasing rates among the youth warrants urgent attention.

When you have uncontrolled high blood pressure, the workload on your heart muscle is increased — this could result in heart failure and damage your arteries, which supply the muscle with oxygen, putting you at risk of a heart attack. Your small arteries could also become damaged, which harms your other organs, such as your kidneys and eyes.11

In an AHA press release, Elaine Urbina, director of preventive cardiology at the Cincinnati Children's Hospital Heart Institute in Ohio, notes that many families and primary care providers are unaware that high blood pressure can begin during childhood, particularly during adolescence, and that poor lifestyle and being overweight and obese are risk factors.12

"The rate of hypertension has to be addressed. Otherwise, we're going to have people having heart attacks and strokes at a young age," she comments.13

In 2023, Urbina and a team of researchers wrote a study, published in the journal Hypertension,14 about primary hypertension among the youth. They found that young people who develop primary hypertension during their childhood or adolescence tend to maintain their levels in adulthood, raising their risk for CVD.

The study also highlighted other risk factors, apart from obesity, that are associated with high blood pressure during childhood, including sleep, suboptimal diet, physical fitness and environmental stress.

"In addition to primordial prevention, regular clinical BP monitoring of all pediatric patients with a standard measurement protocol is recommended to identify children with elevated BP and hypertension. Adolescents entering adulthood with a BP <120/80 mm Hg is an optimal goal," they concluded.15

Make Healthy Changes to Your Child's Diet

As the featured studies mentioned, being overweight or obese is one significant factor that puts children at risk of high blood pressure. According to the CDC, 14.7 million U.S. children ages 2 to 19 are now considered obese — that's 19.7% or nearly one-fifth of all children in the country.16

One major reason for this is the overconsumption of ultraprocessed foods and junk foods, which are rampant in today's modern diet. When children constantly consume these ultraprocessed foods, they're not only feeding on "empty calories," which trigger weight gain — it also sets in motion a catastrophic cascade of health declines rooted in mitochondrial dysfunction and insulin resistance.

The primary reason for this is that ultraprocessed foods are loaded with seed oils that contain linoleic acid (LA). This polyunsaturated fat (PUFA) is the most pernicious ingredient in the modern diet, and is far worse than sugar.

LA is a significant contributor to all diseases, including obesity. Hence, eliminating all sources of seed oils in your child's diet or limiting it to 5 grams per day (or better yet, 2 grams) is an important strategy to minimize their risk of obesity and high blood pressure.

Eating a lot of processed foods, which contain processed table salt, will also cause your child's sodium-to-potassium ratio to be out of balance, which is a significant contributor to high blood pressure.

Contrary to popular belief, a restrictive low-salt diet is not the key to addressing high blood pressure. When salt intake is reduced, total cholesterol to high-density lipoprotein (HDL) ratio worsens — meaning your heart disease risk increases instead. Salt deficiency also increases your chances of developing insulin resistance, because one of the ways in which your body preserves salt is by raising your insulin level.

Rather, you want to optimize your sodium-to-potassium ratio. Potassium works in your body to relax artery walls, keep your muscles from cramping and lower your blood pressure. To do this, make sure you and your child eat a diet of whole, unprocessed foods, ideally organically and locally grown for optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium.

As noted by the AHA, "Foods with potassium can help control blood pressure by blunting the effects of sodium. The more potassium you eat, the more sodium you process out of the body."17

Lack of Sleep Is Also Linked to High Blood Pressure in Children

Evaluating your child's bedtime habits is also important to manage their blood pressure. In a June 2024 study published in the journal Pediatrics,18 researchers found that children who aren't getting enough sleep regularly have an increased risk of developing high blood pressure.

The sample included 539 children and adolescents between 4 and 22 years old, with a mean age of 14.6 years). Of these patients, 56% met the criteria for high blood pressure. Aside from documenting the time they sleep and wake up, the study participants also wore blood pressure monitoring devices which took constant readings 24/7.19

The researchers found that the average sleep duration was 9.1 hours. Depending on the age, this is anywhere from one to four hours less than recommended. They also discovered an association between longer sleep duration and better blood pressure parameters during daytime. Meanwhile, later sleep onset was associated with worse daytime blood pressure parameters.20

"Longer sleep duration and earlier sleep onset were associated with lower blood pressure. This suggests that sleep optimization may be an important target for intervention in hypertension management," they concluded.21

According to Dr. Amy Kogon, an assistant professor at the University of Pennsylvania Perelman School of Medicine and the study's lead author, as many as one-third of children in elementary school do not get the recommended amount of sleep. Most doctors also do not provide enough guidance about sleep to parents when counseling them about high blood pressure.

"We usually target things like diet and exercise. This is another thing parents might want to think about, particularly if the child has high blood pressure," she said.22

One of the best strategies to help optimize your child's sleep is to reduce their gadget use, especially during bedtime. A recent experiment conducted on 10 teenagers found that when they stopped using their smartphones for a month, one of the top benefits was noticeably improved sleep — the teens experienced both longer sleep duration and better sleep quality during the detox period.

However, there are other helpful techniques to help optimize your child's sleep. For a detailed guide, I recommend reading my article, "Top 33 Tips to Optimize Your Sleep Routine."

Sources and References

• 1 American Heart Association, Hypertension in Young Adults: Social Determinants of Prevalence, Awareness, Treatment, and Control, 2024
• 2, 3, 4 American Heart Association, High blood pressure a concern for adolescents and young adults in U.S., September 5, 2024
• 5 American Heart Association, Hypertension Prevalence Among Youth Aged 8–19 Years in a National Survey — United States, 2017–2020
• 6, 7, 8, 9, 12, 13 American Heart Association, 1 in 7 kids in US may have blood pressure that's higher than normal, September 5, 2024
• 10 CDC, Heart Disease Facts
• 11 American Heart Association, High Blood Pressure and Your Kidneys
• 14 Hypertension, March 30, 2023, Volume 80, Number 6
• 15 Hypertension, March 30, 2023, Volume 80, Number 6, Conclusions
• 16 CDC, Childhood Obesity Facts (Archived)
• 17 American Heart Association, A Primer on Potassium
• 18 Pediatrics (2024) 154 (1): e2023062940
• 19 National Heart, Lung and Blood Institute, June 19, 2024
• 20 Medical Xpress, June 19, 2024
• 21 Pediatrics (2024) 154 (1): e2023062940, Conclusions
• 22 NBC News, June 18, 2024