Ruan Xiaorui, Zhu Anji, Wang Tingting, Sun Mengting, Chen Kebin, Luo Manjun, Li Zhanwen, Zou Qi, Chen Ye, Peng Yuan, Qin Jiabi
Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
JAMA Pediatr. 2025 Jul 28. doi: 10.1001/jamapediatrics.2025.2206.
Pediatric hypertension predicts adult hypertension and early target organ damage, yet global prevalence estimates based on different diagnostic principles remain scarce.
To estimate global pediatric hypertension prevalence according to different diagnostic principles.
Several databases, including PubMed, Web of Science, Embase, the China National Knowledge Infrastructure (CNKI), and the Wanfang Database, were systematically searched from inception to July 7, 2024.
Studies were included if they were original investigations in children and adolescents younger than 19 years, represented the general population, and provided data on hypertension prevalence.
Data screening and extraction were performed independently by 2 authors. A random-effects model was used to estimate prevalence. Temporal trends, as well as regional and population differences, were explored. Subgroup analyses and meta-regression analyses were performed to identify sources of heterogeneity. Publication bias was assessed by funnel plots and the Egger test.
The primary outcome was pediatric hypertension, categorized into sustained hypertension (persistent diagnosis confirmed on ≥3 separate occasions) and occasional hypertension (initial diagnosis determined by blood pressure measurements on a single screening visit).
A total of 271 studies involving 16 328 individuals with sustained hypertension, 538 735 individuals with occasional hypertension, and 3 609 665 children and adolescents were included for analysis. The global prevalence of pediatric hypertension was 3.89% (95% CI, 3.27%-4.62%) for sustained hypertension and 11.85% (95% CI, 10.98%-12.75%) for occasional hypertension. Increasing trends with time were observed, with an annual increase of 7.20% (95% CI, 4.16%-10.32%; P < .001) from 2006 to 2021 for sustained hypertension and an estimated annual percentage change of 0.33% (95% CI, 0.10%-0.56%) between 1987 and 2022 for occasional hypertension. Additionally, significant differences were observed across geographical regions and population characteristics for the prevalence of pediatric hypertension. Children and adolescents with obesity or overweight (16.35% and 6.79% vs 2.57% [normal weight] for sustained hypertension) had significantly higher prevalence of hypertension.
This systematic review and meta-analysis indicates substantial variations in the global prevalence of sustained and occasional hypertension, highlighting the importance of measurements on multiple occasions to enhance reliability. Notable differences in prevalence across individuals' body mass index values highlight the necessity for targeted interventions to promote healthy lifestyles.
儿童高血压可预测成人高血压和早期靶器官损害，但基于不同诊断原则的全球患病率估计仍然很少。
根据不同诊断原则估计全球儿童高血压患病率。
从数据库建立至2024年7月7日，系统检索了多个数据库，包括PubMed、Web of Science、Embase、中国知网（CNKI）和万方数据库。
纳入针对19岁以下儿童和青少年的原创性调查研究，这些研究代表一般人群，并提供高血压患病率数据。
由2位作者独立进行数据筛选和提取。采用随机效应模型估计患病率。探讨时间趋势以及地区和人群差异。进行亚组分析和meta回归分析以确定异质性来源。通过漏斗图和Egger检验评估发表偏倚。
主要结局为儿童高血压，分为持续性高血压（在≥3次不同场合确诊）和偶发性高血压（单次筛查就诊时通过血压测量确定的初始诊断）。
共纳入271项研究，涉及16328例持续性高血压患者、538735例偶发性高血压患者以及3609665名儿童和青少年进行分析。持续性高血压的全球患病率为3.89%（95%CI，3.27%-4.62%），偶发性高血压为11.85%（95%CI，10.98%-12.75%）。观察到随时间的上升趋势，2006年至2021年持续性高血压的年增长率为7.20%（95%CI，4.16%-10.32%；P < 0.001），1987年至年2022年偶发性高血压的估计年变化百分比为0.33%（95%CI，0.10%-0.56%）。此外，儿童高血压患病率在不同地理区域和人群特征之间存在显著差异。肥胖或超重的儿童和青少年（持续性高血压分别为16.35%和6.79%，而正常体重者为2.57%）高血压患病率显著更高。
这项系统评价和meta分析表明，持续性和偶发性高血压的全球患病率存在很大差异，强调多次测量以提高可靠性的重要性。个体体重指数值之间患病率的显著差异凸显了采取针对性干预措施以促进健康生活方式的必要性。
