Clinical characteristics of childhood essential hypertension before, during, and after the COVID-19 pandemic: a single-center retrospective study.

UNLABELLED: To evaluate temporal differences in the clinical characteristics of children diagnosed with essential hypertension before, during, and after the COVID-19 pandemic. This retrospective single-center study included 311 children aged 6-17 years diagnosed with essential hypertension between February 2018 and April 2025. Patients were classified into pre-pandemic, pandemic, and post-pandemic groups. Clinical blood pressure measurements, 24-h ambulatory blood pressure monitoring (ABPM), body mass index (BMI), antihypertensive medication use, and cardiac and renal evaluation findings were compared between groups. The proportion of diagnosed cases was 26.7% in the pre-pandemic period, 35.0% during the pandemic, and 38.3% in the post-pandemic period. Body mass index values were significantly higher in the post-pandemic group than in the pre-pandemic group (p = 0.002). Nighttime diastolic blood pressure values on ABPM were significantly higher in the post-pandemic group (p < 0.001). Age distribution was similar across periods. The proportion of patients receiving single or multiple antihypertensive medications increased in the post-pandemic period (p = 0.041).

CONCLUSION

Children diagnosed after the pandemic demonstrated higher BMI, increased nighttime diastolic blood pressure, and greater antihypertensive treatment use, suggesting a potentially less favorable clinical profile and the need for continued follow-up. As these findings are derived from a referral-based clinical population, they should not be interpreted as evidence of a population-level increase in childhood hypertension prevalence.

WHAT IS KNOWN: • Previous studies reported increases in blood pressure and obesity in children during the COVID-19 pandemic. • Changes observed in clinical populations may reflect healthcare utilization rather than true population-level prevalence.

WHAT IS NEW: • A higher proportion of diagnosed childhood hypertension cases was observed post-pandemic in a referral-based population. • Post-pandemic patients had higher BMI, higher nighttime diastolic blood pressure, and increased antihypertensive medication use.