The pooled prevalence of hypertension among European children and adolescents was 8% (95% CI, 7-10%), with rates reaching 23% among obese children.
Meta-Analysis (n=179,279)
Yes
Hypertension affects 8% of European children and adolescents, with prevalence surging to 23% among those with obesity, highlighting a significant pediatric cardiovascular risk burden.
Abstract Background Childhood hypertension has been associated with increased blood pressure levels later in life, markers of target organ damage and, recently, adult cardiovascular events. To estimate the potential impact of hypertension in children and adolescents on the long-term cardiovascular health in Europe, comprehensive prevalence estimates are needed. No cross-European study assessing the prevalence of hypertension among children and adolescents is available today. Purpose This systematic review and meta-analysis aim to estimate the prevalence, time-trends and predictors of hypertension among European children and adolescents (1990-present). Methods We included population-based cross-sectional and cohort studies reporting blood pressure in children (≤18 years) from European countries. Studies based on electronic health records or specialist care referrals were excluded. A literature search was conducted in PubMed on January 27, 2025. Risk of bias was assessed using the Hoy et alia tool, and data were synthesized via random-effects meta-analysis. The main outcome was pooled hypertension prevalence. Subgroups were assessed separately and time trends through meta regression. Results We analyzed 56 studies (n=179 279, mean age 12 years) from 18 European countries. The pooled hypertension prevalence was 8% (95% CI, 7-10%) (Fig 1.), and higher in boys (7%, 95% CI, 6-9%) than girls (5%, 95% CI, 4-7%). Among obese children, prevalence was 23% (95% CI, 18-29%) versus 6% (95% CI, 4-9%) in non-obese children. Hypertension prevalence was highest in 10–13-year-olds (8% (95% CI, 5-13%), compared to 6% (95% CI, 4-8%) and 6% (95% CI, 3-9%) in 3–9-year-olds and 14–19-year-olds, respectively (Fig 2.). The risk of bias was judged as moderate or high for most studies, with considerable variability in blood pressure measurement methods. No significant time-trends were observed. Conclusions Hypertension prevalence among European children and adolescents is considerable, particularly among obese, where one-fourth is hypertensive. It is more common among boys and peaks during puberty. These findings should be interpreted with caution due to methodological limitations of the included studies.Fig 1.Pooled hypertension prevalence Fig2.Hypertension prevalence by subgroup
Rietz et al. (Sat,) conducted a meta-analysis in Hypertension (n=179,279). The pooled prevalence of hypertension among European children and adolescents was 8% (95% CI, 7-10%), with rates reaching 23% among obese children.