Pub Date : 2025-12-02DOI: 10.1016/S2352-4642(25)00283-4
Jason M Nagata MD , Jacqueline O Hur BA , Ken Murakami BA , Kyle T Ganson PhD , Jinbo He PhD , Stuart B Murray PhD , Jason M Lavender PhD
Body image concerns among adolescent boys and young men are increasingly recognised as societal ideals shift towards a lean, muscular physique. In severe cases, these pressures can lead to muscle dysmorphia, a specifier of body dysmorphic disorder marked by preoccupation with being too small or insufficiently muscular. Adolescents and young adults are developmentally vulnerable and might be at higher risk for a variety of eating-related and body image-related concerns, including muscle dysmorphia. This narrative Review synthesises current evidence on the epidemiology, assessment, and treatment of muscle dysmorphia in adolescents and young adults to guide clinicians. Although some treatment approaches show promise, outcome data in large, diverse, clinical adolescent samples remain scarce. Muscle dysmorphia-specific preventive strategies are few, although eating disorder prevention programmes show potential for reducing muscle dysmorphia symptoms. Future research should investigate pharmacotherapy and prevention programmes, validate assessment tools across populations, and examine cultural influences internationally. Advancing understanding of muscle dysmorphia will better equip clinicians to identify and address symptoms in adolescents and young adults.
{"title":"Muscle dysmorphia in adolescents and young adults","authors":"Jason M Nagata MD , Jacqueline O Hur BA , Ken Murakami BA , Kyle T Ganson PhD , Jinbo He PhD , Stuart B Murray PhD , Jason M Lavender PhD","doi":"10.1016/S2352-4642(25)00283-4","DOIUrl":"10.1016/S2352-4642(25)00283-4","url":null,"abstract":"<div><div>Body image concerns among adolescent boys and young men are increasingly recognised as societal ideals shift towards a lean, muscular physique. In severe cases, these pressures can lead to muscle dysmorphia, a specifier of body dysmorphic disorder marked by preoccupation with being too small or insufficiently muscular. Adolescents and young adults are developmentally vulnerable and might be at higher risk for a variety of eating-related and body image-related concerns, including muscle dysmorphia. This narrative Review synthesises current evidence on the epidemiology, assessment, and treatment of muscle dysmorphia in adolescents and young adults to guide clinicians. Although some treatment approaches show promise, outcome data in large, diverse, clinical adolescent samples remain scarce. Muscle dysmorphia-specific preventive strategies are few, although eating disorder prevention programmes show potential for reducing muscle dysmorphia symptoms. Future research should investigate pharmacotherapy and prevention programmes, validate assessment tools across populations, and examine cultural influences internationally. Advancing understanding of muscle dysmorphia will better equip clinicians to identify and address symptoms in adolescents and young adults.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 2","pages":"Pages 122-134"},"PeriodicalIF":15.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/S2352-4642(25)00336-0
Karim Mithani , George M Ibrahim
{"title":"The case for action in paediatric neuromodulation","authors":"Karim Mithani , George M Ibrahim","doi":"10.1016/S2352-4642(25)00336-0","DOIUrl":"10.1016/S2352-4642(25)00336-0","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 1","pages":"Page e1"},"PeriodicalIF":15.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/S2352-4642(25)00282-2
Luo Li MPH , Prof Susan M Sawyer MD , Holly Newby MA , Laura Dunstan PhD , Prof Peter S Azzopardi PhD
Efforts to promote adolescent wellbeing are of increasing global interest. Although the ability to measure wellbeing is essential for identifying disparities between and within populations, and for tracking progress in improving wellbeing, the best way to measure this elusive concept in adolescents is unclear. We undertook a scoping review of quantitative measures of subjective wellbeing to identify those used in population studies of adolescents (aged 10–24 years), and mapped the identified measures against an adolescent wellbeing framework developed by the UN H6+ Technical Working Group on Adolescent Health and Well-Being. We also reviewed global surveys of adolescents to identify how wellbeing was measured, and synthesised available data to show the utility of these measures. Our review identified 52 unique measures that had been used with adolescents, of which 19 had been designed or adapted specifically for adolescents. The identified measures aligned reasonably well with the five domains of the UN framework, except for the domain of safety and a supportive environment. KIDSCREEN-52 was the most comprehensive of the identified measures. The single-item Cantril Ladder of life satisfaction has been widely used in multicountry population surveys, and available data showed wide variation by age, gender, and location. In summary, this Review shows that many measures have been used to measure wellbeing in adolescents, although fewer were specifically designed or adapted to use with adolescents. These findings support scalable efforts to quantify wellbeing, which is an important foundation of investments to enhance adolescent wellbeing.
{"title":"Quantitative measures of subjective wellbeing for adolescents: a scoping review and synthesis of comparable data","authors":"Luo Li MPH , Prof Susan M Sawyer MD , Holly Newby MA , Laura Dunstan PhD , Prof Peter S Azzopardi PhD","doi":"10.1016/S2352-4642(25)00282-2","DOIUrl":"10.1016/S2352-4642(25)00282-2","url":null,"abstract":"<div><div>Efforts to promote adolescent wellbeing are of increasing global interest. Although the ability to measure wellbeing is essential for identifying disparities between and within populations, and for tracking progress in improving wellbeing, the best way to measure this elusive concept in adolescents is unclear. We undertook a scoping review of quantitative measures of subjective wellbeing to identify those used in population studies of adolescents (aged 10–24 years), and mapped the identified measures against an adolescent wellbeing framework developed by the UN H6+ Technical Working Group on Adolescent Health and Well-Being. We also reviewed global surveys of adolescents to identify how wellbeing was measured, and synthesised available data to show the utility of these measures. Our review identified 52 unique measures that had been used with adolescents, of which 19 had been designed or adapted specifically for adolescents. The identified measures aligned reasonably well with the five domains of the UN framework, except for the domain of safety and a supportive environment. KIDSCREEN-52 was the most comprehensive of the identified measures. The single-item Cantril Ladder of life satisfaction has been widely used in multicountry population surveys, and available data showed wide variation by age, gender, and location. In summary, this Review shows that many measures have been used to measure wellbeing in adolescents, although fewer were specifically designed or adapted to use with adolescents. These findings support scalable efforts to quantify wellbeing, which is an important foundation of investments to enhance adolescent wellbeing.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 2","pages":"Pages 135-146"},"PeriodicalIF":15.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular disease is an important cause of morbidity and the leading cause of death in children with chronic kidney disease. Cardiovascular disease often begins in early chronic kidney disease, progresses rapidly on dialysis, and might only partly attenuate after successful kidney transplantation. Importantly, many cardiovascular disease risk factors are modifiable when detected early and treated appropriately. Despite advances in treatments and dialysis technology, cardiovascular disease continues to cause substantial morbidity and reduced quality of life. Here we present clinical practice points on the assessment, prevention, and management of cardiovascular disease in children with chronic kidney disease, on dialysis, and after transplantation based on the best available evidence and consensus of experts from the European Society for Paediatric Nephrology. Where high-level evidence is lacking, clearly labelled expert opinion is provided and should be adapted to individual patient needs. These guidance points support timely identification and intervention to reduce cardiovascular risk in the paediatric population with chronic kidney disease.
{"title":"Assessment, prevention, and management of cardiovascular disease risk factors in children with chronic kidney disease, on dialysis and after transplantation: clinical practice recommendations from the European Society for Paediatric Nephrology","authors":"Prof Stella Stabouli MD PhD , Prof Manish D Sinha MRCP PhD , Fabio Paglialonga MD , Prof Justine Bacchetta MD PhD , Julie Bernardor MD PhD , Prof Dorota Drozdz MD , Prof Ali Düzova MD , Prof Charles Ferro MD , Alexander D Lalayiannis FRCPCH PhD , Prof Anette Melk MD PhD , Prof Claus Peter Schmitt MD , Albert Wiegman MD PhD , Prof Elke Wühl MD , Prof Burkhard Tönshoff MD , Prof Rukshana Shroff MD PhD","doi":"10.1016/S2352-4642(25)00334-7","DOIUrl":"10.1016/S2352-4642(25)00334-7","url":null,"abstract":"<div><div>Cardiovascular disease is an important cause of morbidity and the leading cause of death in children with chronic kidney disease. Cardiovascular disease often begins in early chronic kidney disease, progresses rapidly on dialysis, and might only partly attenuate after successful kidney transplantation. Importantly, many cardiovascular disease risk factors are modifiable when detected early and treated appropriately. Despite advances in treatments and dialysis technology, cardiovascular disease continues to cause substantial morbidity and reduced quality of life. Here we present clinical practice points on the assessment, prevention, and management of cardiovascular disease in children with chronic kidney disease, on dialysis, and after transplantation based on the best available evidence and consensus of experts from the European Society for Paediatric Nephrology. Where high-level evidence is lacking, clearly labelled expert opinion is provided and should be adapted to individual patient needs. These guidance points support timely identification and intervention to reduce cardiovascular risk in the paediatric population with chronic kidney disease.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 3","pages":"Pages 216-232"},"PeriodicalIF":15.5,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/S2352-4642(25)00315-3
Stephanie Spaid Miedema , Laura F Chiang , Kerry L D MacQuarrie , Tu Anh Hoang , K L Dunkle , Leanne Riley , Sophie West-Browne , Raphaëlle Rafin , Kyle Bernstein
{"title":"The future of survey research with the world's sexual or gender minority youth","authors":"Stephanie Spaid Miedema , Laura F Chiang , Kerry L D MacQuarrie , Tu Anh Hoang , K L Dunkle , Leanne Riley , Sophie West-Browne , Raphaëlle Rafin , Kyle Bernstein","doi":"10.1016/S2352-4642(25)00315-3","DOIUrl":"10.1016/S2352-4642(25)00315-3","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 2","pages":"Pages 75-77"},"PeriodicalIF":15.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-13DOI: 10.1016/S2352-4642(25)00276-7
Caio B Casella MD PhD , Prof Ronald C Kessler PhD , Zeina Mneimneh PhD , Kathleen R Merikangas PhD , Guilherme V Polanczyk MD PhD , Giovanni A Salum MD PhD
Background
Most evidence on how the COVID-19 pandemic affected adolescent mental health relies on non-probability samples, which can yield unreliable estimates. This study aimed to compare emotional distress among individuals aged 15 years in 2018 and 2022 using nationally representative data, and to examine how sociodemographic correlates of distress differed between these periods.
Methods
We analysed data from the 2018 and 2022 waves of the Programme for International Student Assessment (PISA) in five countries and one territory (Hong Kong, Ireland, Mexico, Panama, Spain, and United Arab Emirates). PISA is a periodic multi-country cross-sectional assessment of students aged 15 years. Emotional distress was measured using items capturing symptoms of anxiety, depression, irritability, and somatisation. Quantile regression models assessed distributional changes between 2018 and 2022; prevalence ratios were calculated to evaluate changes in the proportion of adolescents in 2022 scoring above 2018-based percentiles.
Findings
We included 80 403 adolescents in 2018 and 77 708 in 2022. Emotional distress increased modestly at the median level (0·11 standardised units [95% CI 0·10–0·12]; p<0·0001), with sharper rises among females (0·20 [0·19–0·22]; p<0·0001) than males (0·02 [0·00–0·03]; p=0·015). However, increases were progressively higher at higher percentiles: 0·22 ([0·21–0·23]; p<0·0001) for the 85th percentile, 0·24 ([0·22–0·25]; p<0·0001) for the 90th percentile, and 0·32 ([0·30–0·34]; p<0·0001) for the 95th percentile. Accordingly, prevalence ratios of 2022 proportions above 2018 cutoffs increased progressively at the median (1·15 [1·13–1·16]), 85th (1·66 [1·62–1·70]), 90th (1·88 [1·83–1·94]), and 95th percentiles (2·37 [2·28–2·47]).
Interpretation
Emotional distress among adolescents in most participating countries was higher in 2022 than in 2018, with disproportionate increases in the number of those reporting high degrees of distress. This pattern suggests a widening of vulnerabilities and highlights an urgent need for scalable and context-sensitive responses, such as strengthening school-based supports, integrating mental health into primary care, and expanding digital and community-based interventions.
{"title":"Emotional distress in adolescents in 2018 and 2022: a comparison of cross-sectional national probabilistic samples from six countries","authors":"Caio B Casella MD PhD , Prof Ronald C Kessler PhD , Zeina Mneimneh PhD , Kathleen R Merikangas PhD , Guilherme V Polanczyk MD PhD , Giovanni A Salum MD PhD","doi":"10.1016/S2352-4642(25)00276-7","DOIUrl":"10.1016/S2352-4642(25)00276-7","url":null,"abstract":"<div><h3>Background</h3><div>Most evidence on how the COVID-19 pandemic affected adolescent mental health relies on non-probability samples, which can yield unreliable estimates. This study aimed to compare emotional distress among individuals aged 15 years in 2018 and 2022 using nationally representative data, and to examine how sociodemographic correlates of distress differed between these periods.</div></div><div><h3>Methods</h3><div>We analysed data from the 2018 and 2022 waves of the Programme for International Student Assessment (PISA) in five countries and one territory (Hong Kong, Ireland, Mexico, Panama, Spain, and United Arab Emirates). PISA is a periodic multi-country cross-sectional assessment of students aged 15 years. Emotional distress was measured using items capturing symptoms of anxiety, depression, irritability, and somatisation. Quantile regression models assessed distributional changes between 2018 and 2022; prevalence ratios were calculated to evaluate changes in the proportion of adolescents in 2022 scoring above 2018-based percentiles.</div></div><div><h3>Findings</h3><div>We included 80 403 adolescents in 2018 and 77 708 in 2022. Emotional distress increased modestly at the median level (0·11 standardised units [95% CI 0·10–0·12]; p<0·0001), with sharper rises among females (0·20 [0·19–0·22]; p<0·0001) than males (0·02 [0·00–0·03]; p=0·015). However, increases were progressively higher at higher percentiles: 0·22 ([0·21–0·23]; p<0·0001) for the 85th percentile, 0·24 ([0·22–0·25]; p<0·0001) for the 90th percentile, and 0·32 ([0·30–0·34]; p<0·0001) for the 95th percentile. Accordingly, prevalence ratios of 2022 proportions above 2018 cutoffs increased progressively at the median (1·15 [1·13–1·16]), 85th (1·66 [1·62–1·70]), 90th (1·88 [1·83–1·94]), and 95th percentiles (2·37 [2·28–2·47]).</div></div><div><h3>Interpretation</h3><div>Emotional distress among adolescents in most participating countries was higher in 2022 than in 2018, with disproportionate increases in the number of those reporting high degrees of distress. This pattern suggests a widening of vulnerabilities and highlights an urgent need for scalable and context-sensitive responses, such as strengthening school-based supports, integrating mental health into primary care, and expanding digital and community-based interventions.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 1","pages":"Pages 39-48"},"PeriodicalIF":15.5,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/S2352-4642(25)00281-0
Jiali Zhou PhD , Shiyi Shan MPH , Jing Wu MPH , Yuan Song MNS , Longzhu Zhu MS , Qingying Li BD , Chenhao Zhang MS , Prof Yajie Zhu PhD , Prof Aziz Sheikh MD , Prof Kazem Rahimi FRCP , Peige Song PhD , Prof Igor Rudan MD
<div><h3>Background</h3><div>Childhood hypertension is an important global public health issue, but prevalence estimates remain inconsistent. To date, no meta-analysis has synthesised global prevalence using both in-office blood pressure measurements and combined in-office and out-of-office assessments. We aimed to provide updated global prevalence estimates of childhood hypertension using both diagnostic approaches.</div></div><div><h3>Methods</h3><div>In this systematic review and analysis, we searched PubMed, Embase, and MEDLINE for population-based studies published between Jan 1, 2000, and April 19, 2025, reporting the prevalence of hypertension in the general paediatric population aged 19 years or younger. This was supplemented by eligible studies identified from relevant systematic reviews and manual reference screening. Two reviewers independently screened records for eligibility, extracted study-level data, and assessed the risk of bias. Random-effects meta-analysis was used to estimate pooled prevalence. Subgroup analyses were performed by age, sex, setting (urban <em>vs</em> rural), device, investigation period, BMI group, and WHO and World Bank regions. Meta-regression was performed to examine age-specific prevalence, sex-specific prevalence, and secular trends. Primary outcomes were the prevalence of childhood hypertension assessed using repeated in-office blood pressure measurements based on at least three separate occasions (in-office approach) and a combination of in-office and out-of-office blood pressure measurements (combination approach). This study was registered with PROSPERO, CRD420251057655.</div></div><div><h3>Findings</h3><div>We identified 11 703 records from database searches, supplemented by 87 articles retrieved from relevant systematic reviews and manual reference screening. Ultimately, 96 articles met the inclusion criteria, all of which were rated with quality scores of at least 5. For the in-office approach, 83 articles included a total of 443 914 children and adolescents across 21 countries. Based on 81 articles, the pooled prevalence of childhood hypertension was 4·28% (95% CI 3·71–4·90). Prevalence increased with age, peaking at 14 years before declining. Between 2000 and 2020, the prevalence of childhood hypertension nearly doubled, increasing from 3·40% (95% CI 2·14–5·34) to 6·53% (4·17–10·07) in boys and from 3·02% (1·90–4·75) to 5·82% (3·71–9·01) in girls. Regarding the combination approach, 15 articles included 12 597 children and adolescents across nine countries. The pooled prevalence was 6·67% (95% CI 1·66–14·53) for sustained hypertension based on five articles.</div></div><div><h3>Interpretation</h3><div>Childhood hypertension affects a substantial and growing proportion of the global paediatric population, with prevalence varying considerably by diagnostic approach. These findings underscore the need for harmonised diagnostic criteria in paediatric hypertension research.</div></div><div><h3>Funding<
儿童高血压是一个重要的全球公共卫生问题，但患病率估计仍不一致。迄今为止，还没有荟萃分析综合了办公室内血压测量和办公室内外联合评估的全球患病率。我们的目的是使用这两种诊断方法提供最新的全球儿童高血压患病率估计。方法在这项系统评价和分析中，我们检索了PubMed、Embase和MEDLINE，检索了2000年1月1日至2025年4月19日期间发表的基于人群的研究，这些研究报告了19岁或以下的普通儿科人群中高血压的患病率。通过相关系统评价和人工参考筛选确定的符合条件的研究作为补充。两名审稿人独立筛选合格记录，提取研究水平数据，并评估偏倚风险。随机效应荟萃分析用于估计合并患病率。按年龄、性别、环境（城市与农村）、设备、调查期间、BMI组以及世卫组织和世界银行所在地区进行亚组分析。采用meta回归来检查特定年龄的患病率、特定性别的患病率和长期趋势。主要结局是儿童高血压的患病率评估，使用至少三个独立场合的反复办公室血压测量（办公室方法）和办公室内外血压测量的结合（联合方法）。本研究注册号为PROSPERO， CRD420251057655。结果：我们从数据库检索中确定了11703条记录，并从相关系统综述和人工参考文献筛选中检索了87篇文章。最终，96篇文章符合纳入标准，所有文章的质量评分至少为5分。对于在职方法，83篇文章共包括21个国家的443 914名儿童和青少年。基于81篇文章，儿童高血压的总患病率为4.28% （95% CI 3.71 ~ 1.90）。患病率随着年龄的增长而增加，在14岁时达到峰值，然后下降。2000年至2020年间，儿童高血压患病率几乎翻了一番，男孩从3.40% （95% CI 2.14 - 5.34）增加到6.53%(4.17 - 10.07)，女孩从3.02%（1.90 - 4.75）增加到5.82%（3.71 - 9.01）。关于联合方法，15篇文章包括9个国家的12597名儿童和青少年。根据5篇文献，持续高血压的总患病率为6.67% （95% CI 1.66 - 14.53）。儿童高血压影响了全球儿科人口中相当大且不断增长的比例，其患病率因诊断方法而异。这些发现强调了在儿科高血压研究中统一诊断标准的必要性。国家自然科学基金。
{"title":"Global prevalence of hypertension among children and adolescents aged 19 years or younger: an updated systematic review and meta-analysis","authors":"Jiali Zhou PhD , Shiyi Shan MPH , Jing Wu MPH , Yuan Song MNS , Longzhu Zhu MS , Qingying Li BD , Chenhao Zhang MS , Prof Yajie Zhu PhD , Prof Aziz Sheikh MD , Prof Kazem Rahimi FRCP , Peige Song PhD , Prof Igor Rudan MD","doi":"10.1016/S2352-4642(25)00281-0","DOIUrl":"10.1016/S2352-4642(25)00281-0","url":null,"abstract":"<div><h3>Background</h3><div>Childhood hypertension is an important global public health issue, but prevalence estimates remain inconsistent. To date, no meta-analysis has synthesised global prevalence using both in-office blood pressure measurements and combined in-office and out-of-office assessments. We aimed to provide updated global prevalence estimates of childhood hypertension using both diagnostic approaches.</div></div><div><h3>Methods</h3><div>In this systematic review and analysis, we searched PubMed, Embase, and MEDLINE for population-based studies published between Jan 1, 2000, and April 19, 2025, reporting the prevalence of hypertension in the general paediatric population aged 19 years or younger. This was supplemented by eligible studies identified from relevant systematic reviews and manual reference screening. Two reviewers independently screened records for eligibility, extracted study-level data, and assessed the risk of bias. Random-effects meta-analysis was used to estimate pooled prevalence. Subgroup analyses were performed by age, sex, setting (urban <em>vs</em> rural), device, investigation period, BMI group, and WHO and World Bank regions. Meta-regression was performed to examine age-specific prevalence, sex-specific prevalence, and secular trends. Primary outcomes were the prevalence of childhood hypertension assessed using repeated in-office blood pressure measurements based on at least three separate occasions (in-office approach) and a combination of in-office and out-of-office blood pressure measurements (combination approach). This study was registered with PROSPERO, CRD420251057655.</div></div><div><h3>Findings</h3><div>We identified 11 703 records from database searches, supplemented by 87 articles retrieved from relevant systematic reviews and manual reference screening. Ultimately, 96 articles met the inclusion criteria, all of which were rated with quality scores of at least 5. For the in-office approach, 83 articles included a total of 443 914 children and adolescents across 21 countries. Based on 81 articles, the pooled prevalence of childhood hypertension was 4·28% (95% CI 3·71–4·90). Prevalence increased with age, peaking at 14 years before declining. Between 2000 and 2020, the prevalence of childhood hypertension nearly doubled, increasing from 3·40% (95% CI 2·14–5·34) to 6·53% (4·17–10·07) in boys and from 3·02% (1·90–4·75) to 5·82% (3·71–9·01) in girls. Regarding the combination approach, 15 articles included 12 597 children and adolescents across nine countries. The pooled prevalence was 6·67% (95% CI 1·66–14·53) for sustained hypertension based on five articles.</div></div><div><h3>Interpretation</h3><div>Childhood hypertension affects a substantial and growing proportion of the global paediatric population, with prevalence varying considerably by diagnostic approach. These findings underscore the need for harmonised diagnostic criteria in paediatric hypertension research.</div></div><div><h3>Funding<","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"10 1","pages":"Pages 11-21"},"PeriodicalIF":15.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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