Ambulatory blood pressure monitoring and neurocognitive function in children with primary hypertension

• Type of Material: Article
• Authors: Juan C. Kupferman, Maimonides Hospital; Donald Batisky, Emory University; Joshua Samuels, McGovern Medical School; Heather R. Adams, University of Rochester; Stephen R. Hooper, University of North Carolina; Hongyue Wang, University of Rochester; Marc B. Lande, University of Rochester
• Language: English
• Date: 2018-10-01
• Publisher: Springer
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018, IPNA.
• Final Published Version (URL): http://dx.doi.org/10.1007/s00467-018-3954-y
• Title of Journal or Parent Work: Pediatric Nephrology
• Volume: 33
• Issue: 10
• Start Page: 1765
• End Page: 1771
• Grant/Funding Information: This work was funded by a grant from the National Heart, Lung, and Blood Institute (R01HL098332, MBL).
• Keywords: RENAL-TRANSPLANTATION; GLOMERULAR-DISEASE; CHILDHOOD; VARIANTS; RECURRENCE; Science & Technology; GENE; Life Sciences & Biomedicine; RESISTANT NEPHROTIC SYNDROME; MUTATIONS; Urology & Nephrology; Adolescence; Hypertension; Pediatric; PODOCYTE; Obesity; Neuropsychological testing; FOCAL-SEGMENTAL GLOMERULOSCLEROSIS; Pediatrics
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background: Children with primary hypertension have been reported to have diminished scores in measures of cognition. However, little is known about the relative correlation between office and ambulatory blood pressure (BP) and neurocognitive test performance, and whether short-term BP variability is associated with decreased neurocognitive function. We sought to determine whether ambulatory BP monitoring (ABPM) was more strongly associated with neurocognitive test performance compared with office BP, and whether increased short-term BP variability was associated with lower neurocognitive scores. Methods: Seventy-five subjects ages 10–18 years, with untreated primary hypertension, and 75 matched normotensive controls completed neurocognitive testing. All subjects had office BP and ABPM prior to neurocognitive testing. Results: On multivariate analyses, there was no significant association between office BP and neurocognitive tests. However, several ABPM parameters were significantly associated with neurocognitive test scores in the lower quartile, in particular 24 h SBP load and wake systolic blood pressure (SBP) index [Rey Auditory Verbal learning Test (RAVLT) List A Trial 1, 24 h SBP load, odds ratio (OR) = 1.02, wake SBP index, OR = 1.06; List A Total, 24 h SBP load, OR = 1.02, wake SBP index, OR = 1.06; Short Delay Recall, wake SBP index, OR = 1.06; CogState Maze delayed recall, 24 h SBP load, OR = 1.03, wake SBP index, OR = 1.08; Grooved Pegboard, 24 h SBP load, OR = 1.02; all p < 0.05]. In contrast, short-term BP variability measures were not associated with neurocognitive test performance. Conclusions: ABPM is superior to office BP in distinguishing hypertensive youth with lower neurocognitive test performance.