Neurocognitive Function in Children with Primary Hypertension

• Type of Material: Article
• Authors: Marc B. Lande, University of Rochester; Donald Lee Batisky, Emory University; Juan C. Kupferman, Maimonides Medical Center; Joshua Samuels, University of Texas at Houston; Stephen R. Hooper, University of North Carolina; Bonita Falkner, Thomas Jefferson University; Shari R. Waldstein, University of Maryland; Peter G. Szilagyi, University of California Los Angeles; Hongyue Wang, University of Rochester; Jennifer Staskiewicz, University of Rochester; Heather R. Adams, University of Rochester
• Language: English
• Date: 2017-01-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jpeds.2016.08.076
• Title of Journal or Parent Work: Journal of Pediatrics
• ISSN: 0022-3476
• Volume: 180
• Start Page: 148
• End Page: +
• Grant/Funding Information: Funded by the National Heart, Lung, and Blood Institute (R01HL098332 [to M.L.]).
• Keywords: EXECUTIVE FUNCTION; ADOLESCENTS; ASSOCIATION; UNITED-STATES; EXTERNALIZING BEHAVIOR; Life Sciences & Biomedicine; PREHYPERTENSION; Pediatrics; MIDLIFE BLOOD-PRESSURE; PERFORMANCE; Science & Technology; COGNITIVE FUNCTION; OBESITY
• Research Categories: Psychology, General; Health Sciences, Medicine and Surgery

Abstract

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.