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May 24, 2026Clinical HypertensionOpen Access

Global trends and geographic variations of hypertension in childhood and adolescence 1990–2021: a systematic analysis of the Global Burden of Disease Study 2021

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Why the study?

Childhood hypertension is strongly associated with adult cardiovascular disease, making understanding epidemiological patterns of disease burden crucial for developing effective prevention strategies.

Population

Individuals under the age of 20 across 204 countries and territories

Comparison

High systolic blood pressure burden trends and regional disparities from 1990 to 2021

Design

Cross-sectional study using Global Burden of Disease Study 2021 data

Key result

The global disability-adjusted life year (DALY) rate attributable to high systolic blood pressure among children and adolescents decreased by 20.11% from 1990 to 2021, reaching 2.39 per 100,000.

Authors

YCYu Hyeon ChuJKJae‐Joong KimSOSarah Soyeon Oh

Discussion

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Overview

Declining global pediatric hypertension DALY rates support surveillance; leaves open regional drivers and prevention needs.

Key Points

  • This analysis aims to understand the epidemiological trends and geographic variations of childhood hypertension from 1990 to 2021.
  • Cross-sectional study utilizing data from the Global Burden of Disease Study 2021, covering 204 countries and territories.
  • Estimation of deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to high systolic blood pressure in individuals under 20.
  • Examination of correlations between DALY rates and socio-demographic indices (SDI).
  • In 2021, the global DALY rate for childhood hypertension was 2.39 per 100,000 population, representing a 20.11% decrease since 1990 (95% UI, −35.02 to 10.21).
  • The YLL rate decreased by 21.06% (95% UI, −36.21 to 9.95), while the YLD rate increased by 22.33% (95% UI, 4.16 to 40.74).
  • The analysis highlighted the highest burden of disease in the Middle East and North Africa (MENA) region, with significant increases in high-income North America since 1990.

Study Design

Type

Cross-Sectional

Structured PICO

P
Population
Individuals under the age of 20 across 204 countries and territories from the Global Burden of Disease Study (GBD) 2021
O
Outcome
Deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to high systolic blood pressurehard clinical

Main Result

Effect estimate: -20.11% change (95% CI -35.02 to 10.21)

Absolute Event Rate: 2.39% vs 2.99%

While the global burden of high systolic blood pressure in youth has generally declined since 1990, significant regional disparities persist, highlighting the need for targeted prevention strategies.

Limitations

  • Unable to differentiate the burden of primary and secondary hypertension
  • Relied on DALY and mortality metrics without providing prevalence data
  • Missing data in some regions, accessibility barriers, and variable data quality in the GBD dataset
  • Relied on predictive models using covariates in regions with data constraints
  • Does not directly account for the temporal latency between elevated BP in childhood and subsequent cardiovascular events in adulthood

Cite This Study

Chu et al. (2026) conducted a cross-sectional in High systolic blood pressure (childhood hypertension). High systolic blood pressure vs. 1990 baseline was evaluated on Global DALY rate per 100,000 population (-20.11% change, 95% CI -35.02 to 10.21). The global disability-adjusted life year (DALY) rate attributable to high systolic blood pressure among children and adolescents decreased by 20.11% from 1990 to 2021, reaching 2.39 per 100,000.

synapsesocial.com/papers/6a129aee48a0ea1665674093https://doi.org/10.5646/ch.2026.32.e30
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Burden of Disease Attributable to High Systolic Blood Pressure in Young Adults: An Analysis From the Global Burden of Disease Study 20212025
  2. 2Age, sex, income, sociodemographic and health system inequalities in the global burden of high systolic blood pressure: an analysis of the Global Burden of Disease Study 20212025 · 3 citations
  3. 3The global burden of hypertension and its epidemiological impacts on adolescents and young adults: projections to 20502025 · 3 citations
  4. 4Trends in the global, regional, and national burden of cardiovascular diseases attributed to high systolic blood pressure from 1990 to 2021 and projections to 2045: a systematic analysis based on GBD 2021 data2025 · 7 citations
  5. 5Global pattern, trend, and cross-country inequality of cardiovascular diseases caused by hypertension from 1990 to 2021, with projection from 2022 to 20602025 · 3 citations