Childhood High Blood Pressure Linked to 40-50% Higher Risk of Early Cardiovascular Death

Children with higher blood pressure measurements at age 7 face a substantially increased risk of dying from cardiovascular disease by their mid-50s, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. The study, simultaneously published in JAMA, found that both elevated blood pressure (90-94th percentile) and hypertension (≥95th percentile) were associated with approximately 40% to 50% higher risk of early cardiovascular death in adulthood.

The research analyzed data from approximately 38,000 children who participated in the Collaborative Perinatal Project, the largest U.S. study documenting pregnancy and postnatal factors' influence on child health. Researchers used the National Death Index to track survival and cause of death through 2016, finding that children whose blood pressure measurements were in the top 10% for their age, sex, and height faced the highest risk. By 2016, a total of 2,837 participants had died, with 504 deaths attributed to cardiovascular disease.

Dr. Alexa Freedman, lead author of the study and assistant professor at Northwestern University's Feinberg School of Medicine, stated, "We were surprised to find that high blood pressure in childhood was linked to serious health conditions many years later. Our results highlight the importance of screening for blood pressure in childhood and focusing on strategies to promote optimal cardiovascular health beginning in childhood." The findings emphasize that blood pressure matters at all ages, and even moderate elevations within the normal range increased cardiovascular death risk by 13-18%.

The study's sibling analysis revealed that children with higher blood pressure at age 7 had similar increases in cardiovascular death risk compared to their siblings with lower readings, indicating that shared family and early childhood environment could not fully explain the impact. This suggests that blood pressure itself, rather than just familial factors, plays a crucial role in long-term cardiovascular health outcomes. The research supports the American Academy of Pediatrics' clinical practice guidelines recommending blood pressure checks at annual well-child appointments starting at age 3.

Dr. Bonita Falkner, an American Heart Association volunteer expert not involved in the study, noted that "the results of this study support monitoring blood pressure as an important metric of cardiovascular health in childhood" and will contribute to more accurate definitions of abnormal blood pressure in children. The study limitations include using a single blood pressure measurement at age seven and primarily including Black or white participants, which may limit generalizability to other racial or ethnic groups.