Although mean levels of systolic and diastolic blood pressure (BP) have declined overall in US children and adolescents during the past 20 years, recent patterns raise concerns about a reversal of this trend, according to a study published in JAMA Network Open. Investigators used data from the National Health and Nutrition Examination Survey (1999-2002 to 2015- 2018; 9,117 children aged 8-12 and 10,156 adolescents aged 13-17) to assess changes in systolic BP (SBP) and diastolic BP (DBP) levels among US children during the past 20 years. Among children aged 8-12, the ageadjusted mean SBP decreased from 102.4 mm Hg in 1999-2002 to 101.5 mm Hg in 2011- 2014 and then increased to 102.5 mm Hg in 2015-2018, while age-adjusted mean DBP decreased from 57.2 mm Hg in 1999-2002 to 51.9 mm Hg in 2011-2014 and then increased to 53.2 mm Hg in 2015-2018. Among adolescents aged 13-17, age-adjusted mean SBP decreased from 109.2 mm Hg in 1999-2002 to 108.4 mm Hg in 2011-2014 and then remained unchanged in 2015-2018, while mean DBP decreased from 62.6 mm Hg in 1999-2002 to 59.6 mm Hg in 2011-2014 and then increased to 60.8 mm Hg in 2015-2018. Compared with levels in normalweight children, mean SBP and mean DBP were higher in overweight and obese children aged 8-12. In adolescents, SBP was higher among boys versus girls and among non-Hispanic Black versus White participants. “Stable or increased BP levels and hypertension prevalence from 2011-2014 to 2015-2018 could indicate a reversal of these trends,” the study authors write.