Executive function and cerebrovascular reactivity in pediatric hypertension
Maria A Ostrovskaya1, Mary Rojas2, Juan C Kupferman3
1Center for Brain and Behavior, Maimonides Medical Center, Brooklyn, NY, USA.
Journal of Child Neurology
|July 24, 2013
Summary
Children with hypertension show reduced executive function and impaired cerebrovascular reactivity. This study links poorer cognitive performance in hypertensive children to decreased brain blood flow regulation.
Area of Science:
- Pediatric Cardiology
- Neuroscience
- Vascular Biology
Background:
- Primary hypertension in children is linked to cognitive deficits.
- Cerebrovascular reactivity is often impaired in hypertensive individuals.
Purpose of the Study:
- To investigate the relationship between executive function and cerebrovascular reactivity in children with hypertension and prehypertension.
- To determine if the brain is a target organ in pediatric hypertension.
Main Methods:
- 14 children with hypertension/prehypertension underwent 24-hour ambulatory blood pressure monitoring.
- Transcranial Doppler assessed cerebrovascular reactivity during hypercapnia-rebreathing tests.
- Parents completed the Behavior Rating Inventory of Executive Functions (BRIEF) for children.
Main Results:
- Children with hypertension exhibited significantly lower cerebrovascular reactivity slopes compared to historical controls (P < .001).
- A significant inverse correlation was found between BRIEF scores (Behavioral Regulation Index, Metacognition Index, Global Executive Component) and reactivity slopes (P ≤ .05).
Conclusions:
- Hypertensive children demonstrate decreased executive function.
- Impaired cerebrovascular reactivity in these children correlates with reduced executive function, suggesting the brain is an affected organ.
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