High blood pressure in children is rising - new guidelines are here to help

Experts are calling for blood pressure checks to become a routine part of childhood healthcare starting at the age of seven, as some primary school aged children are experiencing high blood pressure patterns that could be setting them up for heart attacks, strokes and kidney disease later in life. 

The guidelines were developed by Edith Cowan University’s Nutrition and Health Innovation Research Institute and Murdoch Children’s Research Institute (MCRI) in partnership with Hypertension Australia. 

Lead author Dr Nicholas Larkins, senior research fellow at ECU and Consultant Paediatrician in Metabolic Medicine, said doctors were regularly seeing children as young as seven and eight years old with high blood pressure who already have organ damage, including thickening of the heart muscle.

“It’s a silent disease. One in 11 Australian children now have high blood pressure, which is often symptom-free. It can damage young bodies for years before it’s picked up,” he said. 

MCRI’s Associate Professor Jonathon Mynard said the new guidelines were the first to provide a clear pathway for identifying and managing high blood pressure among Australian children and adolescents. 

“Previous guidelines haven’t covered children because the evidence linking blood pressure in childhood and later health conditions was less certain," he said.

"But now we have multiple, large long-term studies demonstrating strong links to adverse health outcomes,” he said. 

Hypertension Australia President Professor Markus Schlaich said the new guidelines addressed a long-standing gap in paediatric care. 

“Many people still think of high blood pressure as something that only affects older adults, but that’s clearly not the case,” he said.   

The guideline states that while childhood obesity is the main driver of increasing rates of hypertension, other factors include diets high in salt and processed food, not enough exercise, too much screen time, family history of high blood pressure, being born prematurely or small for age, and economic disadvantage. 

The authors said the most important action for children with hypertension was lifestyle changes, which could reverse or delay the need for medical intervention.  

“The most important interventions are often the simplest,” Dr Larkins said. 

“Improving diet, increasing physical activity, reducing salt intake, and helping families make sustainable lifestyle changes can make a real difference to blood pressure and long-term health outcomes.” 

He said blood pressure checks should be part of routine health care for children, just like height, weight and vision checks. 

The guidelines have been published in the Journal of Paediatrics and Child Health and endorsed by the Heart Foundation.