Neurocognitive alterations in hypertensive children and adolescents

Abstract

Hypertensive adults demonstrate performance deficits on neuropsychological testing compared with scores of normotensive controls. This article reviews emerging preliminary evidence that children with hypertension also manifest neurocognitive differences when compared with normotensive controls. Database and single-center studies suggest that children with hypertension manifest deficits on measures of neurocognition and have an increased prevalence of learning difficulties and that children with hypertension associated with obesity may be at increased risk for depression and anxiety. Studies suggesting blunted cerebrovascular reactivity in children with hypertension are also reviewed.

Figure FIGURE

Mean change in Behavior Rating Inventory of Executive Function (BRIEF) and Achenbach Child Behavior Checklist (CBCL) summary scores from baseline to 12 months in hypertensive patients by initial 24‐hour systolic blood pressure (SBP) load. A decrease in T scores (negative change) represents improvement. *P<.05, **P<.005; within‐patient change, 12 months to baseline, adjusted for age, race, body mass index percentile, sex, and maternal education. BRIEF scores improved after 12 months of antihypertensive therapy in hypertensive patients with an initial SBP >50% but not in those with an SBP <50%. There was no difference in CBCL score change by SBP load. BRI indicates Behavior Regulation Index; MI, Metacognition Index; GEC, Global Executive Composite. Reprinted with permission. ³²