Neurocognitive Function in Children with Primary Hypertension
Marc B Lande1, Donald L Batisky2, Juan C Kupferman3
1Department of Pediatrics, University of Rochester, Rochester, NY.
Insights
Children with primary hypertension show impaired neurocognitive function, particularly in memory, attention, and executive functions, compared to healthy peers. Disordered sleep exacerbates these cognitive deficits in hypertensive youth.
Area of Science:
- Pediatric Health
- Neuroscience
- Cardiovascular Health
Background:
- Primary hypertension is increasingly diagnosed in children and adolescents.
- The impact of pediatric hypertension on cognitive development and function is not fully understood.
- Early identification of cognitive deficits is crucial for timely intervention.
Purpose of the Study:
- To compare neurocognitive test performance between children with newly diagnosed primary hypertension and normotensive controls.
- To investigate specific cognitive domains affected by pediatric hypertension.
- To explore the relationship between disordered sleep and executive function in hypertensive youth.
Main Methods:
- A prospective, multicenter study involving 75 children (10-18 years) with untreated primary hypertension and 75 matched normotensive controls.
- Comprehensive neurocognitive testing assessing general intelligence, attention, memory, executive function, and processing speed.
- Parental rating scales for executive function and sleep-related breathing disorders (PSQ-SRBD).
Main Results:
- Hypertensive youth exhibited significantly worse performance on memory (Rey Auditory Verbal Learning Test), executive function (Groton Maze Learning Test), and processing speed (Grooved Pegboard).
- Hypertension was independently associated with lower scores on intelligence (Wechsler Abbreviated Scales of Intelligence Vocabulary).
- A significant interaction revealed that hypertension amplified the negative impact of disordered sleep on executive function.
Conclusions:
- Youth with primary hypertension demonstrate impaired neurocognitive performance compared to normotensive children.
- Key affected domains include memory, attention, and executive functions.
- Disordered sleep significantly exacerbates executive function deficits in children with primary hypertension.
Objective:
To compare neurocognitive test performance of children with primary hypertension with that of normotensive controls.
Study Design:
Seventy-five children (10-18 years of age) with newly diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed. Parents completed rating scales of executive function and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ-SRBD).
Results:
Hypertension and control groups did not differ significantly in age, sex, maternal education, income, race, ethnicity, obesity, anxiety, depression, cholesterol, glucose, insulin, and C-reactive protein. Subjects with hypertension had greater PSQ-SRBD scores (P = .04) and triglycerides (P = .037). Multivariate analyses showed that hypertension was independently associated with worse performance on the Rey Auditory Verbal Learning Test (List A Trial 1, P = .034; List A Total, P = .009; Short delay recall, P = .013), CogState Groton Maze Learning Test delayed recall (P = .002), Grooved Pegboard dominant hand (P = .045), and Wechsler Abbreviated Scales of Intelligence Vocabulary (P = .016). Results indicated a significant interaction between disordered sleep (PSQ-SRBD score) and hypertension on ratings of executive function (P = .04), such that hypertension heightened the association between increased disordered sleep and worse executive function.
Conclusions:
Youth with primary hypertension demonstrated significantly lower performance on neurocognitive testing compared with normotensive controls, in particular, on measures of memory, attention, and executive functions.
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