High blood pressure in childhood may have long-term consequences for heart health, new research suggests.
Children with elevated blood pressure at age 7 face a higher risk of dying from cardiovascular disease by their mid-50s, according to preliminary findings presented at the American Heart Association’s Hypertension Scientific Sessions 2025 in Baltimore.
Past research has connected elevated blood pressure in older children to increased cardiovascular mortality in adulthood. However, this is the first study to examine the effects of both systolic (top number) and diastolic (bottom number) blood pressure in early childhood across a diverse population.
Current American Academy of Pediatrics guidelines recommend measuring blood pressure at every well-child visit beginning at age 3.
“The results underscore the importance of monitoring blood pressure as a key indicator of cardiovascular health in childhood,” said Bonita Falkner, M.D., FAHA, an emeritus professor at Thomas Jefferson University and American Heart Association volunteer expert, who was not involved in the study.
She noted that such findings could refine the definitions of abnormal blood pressure and pediatric hypertension.
The study analyzed data from the Collaborative Perinatal Project (CPP), a large U.S. study tracking childhood health influences from birth.
Researchers followed nearly 38,000 children whose blood pressure was recorded at age 7, converting measurements to age-, sex-, and height-specific percentiles. They accounted for childhood body mass index and demographic factors to isolate the effect of blood pressure itself.
After following participants through an average age of 54, researchers found:
Children in the top 10% for systolic or diastolic blood pressure had the highest risk of dying early from cardiovascular disease.
By 2016, 2,837 participants had died, including 504 from cardiovascular causes.
Elevated blood pressure (90–94th percentile) and hypertension (≥95th percentile) were associated with a 40–50% higher risk of early cardiovascular death.
Even moderate elevations within the normal range increased risk: 13% for systolic and 18% for diastolic.
Sibling comparisons confirmed that higher childhood blood pressure predicted increased cardiovascular mortality independent of shared family or early-life factors.
“High blood pressure in childhood can have serious, lifelong consequences,” said lead researcher Dr. Earl Freedman. “Parents and clinicians should pay close attention to children’s blood pressure readings.”
The study has limitations, including reliance on a single blood pressure measurement at age 7 and a predominantly Black or white study population, which may limit generalizability. Additionally, lifestyle and environmental factors have evolved since the CPP cohort was born between 1959 and 1965.
Study Details:
38,252 children from 12 U.S. sites; 50.7% male, 49.4% Black mothers, 46.4% white, 4.2% Hispanic, Asian, or other.
Blood pressure measured at age 7, converted to age-, sex-, and height-specific percentiles.
Survival through 2016 tracked via the National Death Index.
Analysis adjusted for BMI, study site, and maternal factors; sibling analysis explored the impact of shared family and early childhood environment.
This research reinforces that early detection and monitoring of blood pressure in children is not just a pediatric formality—it could be a vital predictor of lifelong heart health.
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