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Twenty four-hour blood pressure and cognitive outcomes in adolescents born extremely preterm and at term
Chandelle L Piazza1,2, Lex W Doyle2,3,4,5, Leona Pascoe1,2
1School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
Insights
Higher blood pressure is linked to poorer cognitive function in young adults, regardless of whether they were born extremely preterm or at term. This association was particularly noted for general intelligence and visual memory.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Cardiovascular Research
Background:
- Extremely preterm birth (<28 weeks' gestation) poses risks for neurodevelopmental outcomes.
- Hypertension is a known risk factor for cognitive decline in adults.
- The impact of blood pressure on cognition in extremely preterm individuals is not well understood.
Purpose of the Study:
- To investigate the relationship between blood pressure and cognitive outcomes at 18 years of age.
- To compare these associations in individuals born extremely preterm versus those born at term.
Main Methods:
- Prospective longitudinal cohort study of 136 extremely preterm and 120 term-born individuals.
- Analysis of 24-hour ambulatory blood pressure (mean, systolic, diastolic hypertension).
- Linear regression models used to assess associations with cognitive outcomes.
Main Results:
- Elevated 24-hour mean ambulatory blood pressure and systolic hypertension were associated with similar or worse cognitive outcomes in both groups.
- Strongest associations observed between higher blood pressure and poorer general intellect, visual learning, and visual memory.
- No significant differences in the blood pressure-cognition relationship based on birth group.
Conclusions:
- Higher 24-hour mean ambulatory blood pressure and systolic hypertension are linked to impaired cognitive function.
- These associations are evident in both extremely preterm and term-born individuals.
- General intelligence and visual memory appear particularly affected by elevated blood pressure.
Aim:
To explore the impact of blood pressure on cognitive outcomes at 18 years of age in individuals born extremely preterm (<28 weeks' gestation) and at term (≥37 weeks' gestation).
Methods:
Prospective longitudinal cohort comprising 136 young adults born extremely preterm and 120 matched term controls born in Victoria, Australia in 1991 and 1992. Using linear regression, we analysed the relationships between 24-h mean ambulatory blood pressure, systolic and diastolic hypertension with cognitive outcomes.
Results:
For both birth groups combined, higher 24-h mean ambulatory blood pressure and systolic hypertension were associated with similar or worse cognitive outcomes. The strongest relationships were between higher 24-h mean ambulatory blood pressure and systolic hypertension with poorer general intellect, visual learning and visual memory. We found little evidence that relationships between ambulatory blood pressure and cognitive outcomes differed by birth group.
Conclusion:
Higher 24-h mean ambulatory blood pressure and systolic hypertension were associated with poorer cognitive outcomes in individuals born extremely preterm and at term, particularly in general intelligence and visual memory.
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Monitoring Both Arms:
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