Hypertension in Children: Narrative Review of Epidemiology, Outcome and Target Organ Damage

Hypertension is the leading risk factor for cardiovascular disease. Epidemiologic studies have demonstrated that pediatric hypertension may increase the risk of premature heart disease. Pediatric hypertension affects about 4% of children and clusters with other risk factors and social disparities in health. In addition to observed target organ damage, there is evidence for tracking blood pressure from childhood to adulthood. Ambulatory blood pressure monitoring is the recommended method for diagnosis, and echocardiography is used to assess target organ damage. A diagnostic workup in children depends on the age at presentation, severity of hypertension, diurnal pattern, evidence of target organ damage, and response to treatment. Treatment follows a similar framework to adult hypertension and studies demonstrate improvement in intermediate outcomes with treatment. However, further studies are needed to establish benefit in hard outcomes. This review focuses on studies evaluating the epidemiology of pediatric hypertension and its association with cardiovascular outcomes. Relevant domains included prevalence, blood pressure tracking, and cardiovascular sequelae. To compile data for this narrative review, a PubMed/MEDLINE database search was performed for studies published between 1997 and April 2026.