High blood pressure is often thought of as a health issue that arises in adulthood, but new research suggests its consequences can start decades earlier. According to a landmark study presented at the American Heart Association’s Hypertension Scientific Sessions 2025 in Baltimore and published in JAMA, children as young as seven with elevated blood pressure face a significantly higher risk of premature cardiovascular death. The findings indicate that even modestly higher readings in childhood could translate into a 40% to 50% greater risk of dying from heart disease by midlife. This discovery highlights the importance of regular screening in children and promoting heart-healthy habits early in life to prevent long-term complications.
What childhood blood pressure levels reveal about future health
The study drew on data from the Collaborative Perinatal Project (CPP), one of the most comprehensive studies ever undertaken to understand child development and long-term health. Between 1959 and 1965, more than 38,000 children were enrolled at 12 sites across the United States. At age seven, their blood pressure levels were recorded and adjusted for age, sex, and height, following modern clinical guidelines established by the American Academy of Pediatrics.
To understand the long-term effects, researchers linked this childhood data to the National Death Index, tracking survival and causes of death through 2016. By then, participants had reached an average age of 54. Out of the 38,252 participants, 2,837 had died, with 504 deaths directly attributed to cardiovascular disease such as heart attacks or strokes.
High childhood blood pressure can raise heart risks later in life
The analysis revealed a clear pattern: children with higher blood pressure at age seven were more likely to die from cardiovascular disease in adulthood. The greatest risk was observed among children whose blood pressure readings were in the top 10% for their demographic.
- Elevated blood pressure (90th–94th percentile) was associated with about a 40% higher risk of cardiovascular death.
- Hypertension (≥95th percentile) carried a 50% increased risk of early cardiovascular death.
- Even children with only slightly above-average blood pressure faced increased risks—13% higher for systolic pressure and 18% higher for diastolic pressure—underscoring that danger does not begin only at the hypertension threshold.
This shows that blood pressure exists on a spectrum, where even small elevations can affect long-term outcomes.
Childhood blood pressure affects health later in life
One of the most compelling aspects of the research was its sibling analysis. The study examined 150 clusters of siblings within the CPP dataset. When comparing siblings raised in the same environment, the child with the higher blood pressure reading at age seven still faced a significantly greater risk of cardiovascular death.
- Systolic pressure: 15% higher risk.
- Diastolic pressure: 19% higher risk.
This finding suggests that elevated blood pressure alone—not just family circumstances, lifestyle, or genetics—plays a powerful role in shaping long-term cardiovascular health.
High blood pressure in kids may raise death risk for decades
Lead researcher Dr. Alexa Freedman, assistant professor at Northwestern University’s Feinberg School of Medicine, emphasized the long-reaching effects:“We were surprised to find that high blood pressure in childhood was linked to serious health conditions many years later. Having hypertension or elevated blood pressure as a child may increase the risk of death by 40% to 50% over the next five decades of life.”Independent experts echoed this urgency. Dr. Bonita Falkner, emeritus professor of pediatrics and medicine at Thomas Jefferson University, noted:“The results of this study support monitoring blood pressure as an important metric of cardiovascular health in childhood. These findings will also help refine definitions of abnormal blood pressure in children.”
Why regular blood pressure checks matter for children
Unlike adults, children rarely show obvious symptoms of high blood pressure. Without regular screenings, elevated readings may go unnoticed until damage has already begun. The American Academy of Pediatrics recommends blood pressure checks annually from age three, yet many parents and even pediatric practices overlook this guideline.This study reinforces that such screenings are not optional. Detecting elevated blood pressure early allows for interventions such as encouraging healthy diets, regular physical activity, reduced sodium intake, better sleep habits, and stress management—all of which can reduce cardiovascular risk later in life.While groundbreaking, the research has some limitations. Blood pressure was measured only once at age seven, meaning fluctuations over time were not captured. Additionally, the study population primarily consisted of Black and white children from the 1960s, raising questions about applicability to today’s more diverse populations and different lifestyle exposures. Modern diets, sedentary habits, and environmental factors may alter how childhood blood pressure interacts with long-term health.Nonetheless, the large sample size, decades-long follow-up, and sibling analysis make the results highly credible and relevant.
Rethinking heart health: It starts with children’s blood pressure
The findings highlight a critical shift in how we view cardiovascular risk. Traditionally, heart disease prevention has focused on adult behaviors such as smoking cessation, cholesterol management, and weight control. This research suggests that the seeds of heart disease may be sown much earlier, with childhood blood pressure acting as a silent predictor of lifelong risk.As Dr. Freedman concluded: “Even in childhood, blood pressure numbers are important because high blood pressure in children can have serious consequences throughout their lives. It is crucial to be aware of your child’s readings.”Also Read | 10,000 steps a day vs Japanese interval walking: AIIMS gastroenterologist reveals a more effective way to improve blood pressure and heart health