Childhood Blood Pressure at Age 7 Linked to Higher Risk of Early Cardiovascular Death

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 the American Academy of Pediatrics clinical practice guidelines.

By 2016, after follow-up through an average age of 54 years, 2,837 participants had died, with 504 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 13-18% increased risk of premature cardiovascular death. The study's sibling analysis, examining 150 groups of siblings, found that children with higher blood pressure at age 7 had similar increases in risk compared to their siblings with lower readings, indicating that shared family and early childhood environment could not fully explain the impact.

"We were surprised to find that high blood pressure in childhood was linked to serious health conditions many years later," said lead author Alexa Freedman, Ph.D., assistant professor in the department of preventive medicine at Northwestern University's Feinberg School of Medicine. "Our results highlight the importance of screening for blood pressure in childhood and focusing on strategies to promote optimal cardiovascular health beginning in childhood." Clinical practice guidelines from the American Academy of Pediatrics recommend checking blood pressure at annual well-child pediatric appointments starting at age 3 years. The findings support monitoring blood pressure as an important metric of cardiovascular health in childhood and contribute to more accurate definitions of abnormal blood pressure and hypertension in pediatric populations.

The study has limitations, including reliance on a single blood pressure measurement at age seven and a participant population primarily consisting of Black or white children from the 1960s and 1970s, which may limit generalizability to other racial or ethnic groups and contemporary children with different lifestyles. The research was presented at the American Heart Association's scientific meeting, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. This research underscores that cardiovascular risk factors can manifest early in life, making childhood a critical window for prevention strategies that could reduce premature mortality decades later.