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 and hypertension in childhood 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 between 1959-1965. Blood pressure measurements taken at age 7 were converted to age-, sex-, and height-specific percentiles according to American Academy of Pediatrics clinical practice guidelines. Researchers used the National Death Index to track survival and cause of death through 2016, when participants had reached an average age of 54 years.
By 2016, a total of 2,837 participants had died, with 504 of those deaths attributed to cardiovascular disease. The risk was highest for children whose blood pressure measurements were in the top 10% for their age, sex, and height. Even moderate elevations in blood pressure within the normal range were significant, with children having moderately higher than average blood pressure showing a 13% to 18% higher risk of premature cardiovascular death.
Lead author Alexa Freedman, Ph.D., assistant professor in the department of preventive medicine 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 study's findings have significant implications for pediatric healthcare practices and public health policy. Clinical practice guidelines from the American Academy of Pediatrics already recommend checking blood pressure at annual well-child appointments starting at age 3 years. This research provides stronger evidence supporting the importance of these screenings and early intervention strategies.
Bonita Falkner, M.D., FAHA, an American Heart Association volunteer expert and emeritus professor of pediatrics and medicine at Thomas Jefferson University, commented: "The results of this study support monitoring blood pressure as an important metric of cardiovascular health in childhood. Moreover, the results will contribute to a more accurate definition of abnormal blood pressure and hypertension in childhood."
The study included sibling analysis involving 150 groups of siblings, which found that children with higher blood pressure at age 7 had similar increases in cardiovascular death risk compared to their siblings with lower readings. This indicates that shared family and early childhood environment could not fully explain the impact of blood pressure on mortality risk.
Researchers noted several limitations, including that the analysis used only a single blood pressure measurement at age seven, which may not capture variability or long-term patterns. Additionally, participants were primarily Black or white, so findings may not be generalizable to children of other racial or ethnic groups. Children today also likely have different lifestyles and environmental exposures than those in the original study from the 1960s and 1970s.
The American Heart Association provides additional resources on hypertension through their website at heart.org. The findings underscore the critical importance of early blood pressure monitoring and the development of heart-healthy habits beginning in childhood to reduce long-term cardiovascular risks.
