Hypertension is Not Just an Older Person’s Problem!

When most people think of high blood pressure, or hypertension, they picture older adults. However, a worrying trend is emerging: hypertension is increasingly being diagnosed in young people, including teenagers and even children. This silent condition, often without obvious symptoms, can have lifelong consequences if not recognised and managed early.

Understanding Hypertension in the Young

Credit: Health365.sg

Hypertension is defined as consistently elevated blood pressure above the normal range for age, sex, and height. In adults, the threshold is generally 140/90 mmHg, but in children and adolescents, the diagnosis is based on percentiles adjusted for these factors. According to a systematic review, the global prevalence of hypertension in children and adolescents is about 4%, with pre-hypertension or elevated blood pressure affecting nearly 10% of those under 19 years old. Notably, the East Asian and Pacific regions—including Singapore—bear some of the highest absolute burdens of high blood pressure in youth, and the prevalence is rising in tandem with increasing rates of childhood obesity and sedentary lifestyles.

While Singapore-specific paediatric hypertension data are limited, local studies and Ministry of Health reports indicate that the risk factors and trends mirror those seen across Asia. For example, a study in Singapore found that Malay youths are at higher risk of hypertension compared to other ethnic groups, and that the prevalence of hypertension among adolescents in school-based settings is only slightly lower than in adults. Regional data suggest that between 3% and 5% of children and adolescents in Singapore may have hypertension, with higher rates among those who are overweight or obese.

The causes of hypertension in young people can be divided into two broad categories: primary (essential) and secondary hypertension.

Primary hypertension is increasingly common in older children and adolescents, and is often linked to lifestyle factors. The main contributors include obesity (with up to 30% of obese children showing elevated blood pressure), high intake of salt and processed foods, sedentary behaviour, family history, and stress. Secondary hypertension, more common in younger children, is usually due to underlying medical conditions such as kidney disease, congenital heart defects, or hormonal disorders.

The Hidden Dangers

Hypertension is often called the “silent killer” because it rarely causes symptoms until significant damage has occurred. In young people, the consequences can be particularly severe because the condition may go undetected for years. Some of the long-term risks include heart damage, kidney disease, increased risk of stroke, vision problems, and even cognitive and developmental issues. Research shows that hypertension in childhood often tracks into adulthood, increasing the risk of cardiovascular disease and early death.

Because hypertension is often asymptomatic, regular screening is essential. The American Academy of Pediatrics recommends that children have their blood pressure measured annually from the age of three, and more frequently if they have risk factors such as obesity, kidney disease, or a family history of hypertension. In Singapore, paediatricians and school health services are increasingly aware of the need for early detection, especially as local rates of childhood obesity and diabetes rise.

Prevention and Management

The good news is that hypertension in young people is often preventable and manageable. Key strategies include encouraging a diet rich in fruits, vegetables, and whole grains, limiting salt and processed foods, promoting at least 60 minutes of physical activity daily, maintaining a healthy weight, reducing screen time, and teaching healthy ways to cope with stress. In some cases, medication may be necessary, but lifestyle changes remain the cornerstone of prevention and management.

Parents also play a vital role in modelling healthy behaviours and ensuring regular medical check-ups. Schools can support healthy eating and physical activity through their programmes and policies. Healthcare providers should be vigilant in screening for hypertension and providing guidance on prevention and management.

Hypertension is no longer just a concern for adults. The increasing prevalence among young people, including children, is a public health issue that demands attention in Singapore and across the region. Early detection, healthy lifestyle habits, and appropriate medical care can prevent the serious complications associated with high blood pressure. By working together—families, schools, and healthcare professionals—we can help ensure that the next generation grows up healthy and strong, free from the silent dangers of hypertension.

Hypertension is Not Just an Older Person’s Problem!