- Prevalence of childhood hypertension is
increasing, in parallel with the increase in childhood obesity.
hypertension affects cognition and cognitive development.
children perform poorly in
tests that assess cognitive skills
- Early diagnosis and
treatment of hypertension in children help to reduce or reverse the cognitive
The effects of childhood hypertension
(increased blood pressure) on their cognitive
skills have been
in a recent study.
Up To The Study
The effects of hypertension on the brain
such as posterior reversible encephalopathy syndrome (PRES), infarction and
hemorrhage are known and have been extensively researched. However, it has
recently come to light that such children also have impaired cognitive skills,
causing learning disabilities and defects in executive functions that were
measured using tests and predefined parameters. Studies have also demonstrated
improvement in the cognitive skills and performance of these children following anti-hypertensive treatment
‘Cognitive impairment in childhood hypertension should be addressed to prevent long term effects.’
research has been done in this area, and more studies are needed to understand
the full range of effects of childhood hypertension on the brain in general,
and effects related to cognition in particular
of The Study
B. Lande, MD, MPH, and investigators from the University of Rochester, Emory
University, Maimonides Medical Center, University of Texas at Houston,
University of North Carolina, Thomas Jefferson University, University of
Maryland, and the University of California at Los Angeles, made a comparison of
different tests of cognitive skills between 75 children between the ages of 10
to 18 with newly-diagnosed hypertension and 75 matched children without
hypertension. Children having other factors or conditions known to affect cognitive
skills were excluded from the study (e.g., ADHD
learning disabilities, sleep disorders ).
to Dr. Lande, "We wanted to make sure that if we found differences between
children with and without hypertension, it was likely associated with
hypertension itself, not any of these other factors."
cognitive skills tests conducted measured
aspects such as visual and verbal memory, processing speed, and verbal skills
What The Tests Revealed
researchers found that children with
hypertension fared worse on the tests of cognitive skills
, that were based on the above
parameters. Also many children with sleep disorders
had hypertension and
lack of sleep compounded their poor performance in cognitive tests and
the differences in cognitive abilities and skills of children with
hypertension, and normal children without hypertension were noted to be rather
subtle in this study. The average scores of both groups were largely within the
normal ranges, but the group with hypertension scored lesser in comparison.
This study demonstrates that childhood hypertension
does impair the performance on cognitive testing.
conclusion, more research is required to understand the effects of hypertension
on the pediatric brain, and how these findings may be applied in the areas of
cognition, improving the quality of life and brain health.
Future Research Plans
About Childhood Hypertension
- The team plans to study whether
there are any physical changes present in the brain that might explain the
impaired cognitive abilities of hypertensive children.
Dr. Lande, "In the future, we want to better understand if there are physical
changes to the brain in children who have hypertension that could explain these
cognitive test results."
- They also plan to study if
anti-hypertensive treatment improves cognitive skills in hypertensive children
and can help to reverse or prevent long term adult hypertension associated
prevalence of childhood hypertension is increasing in parallel with the
epidemic of childhood obesity
Prehypertension is defined as blood
pressure measurement between the 90th percentile, and the
, for sex,
height, and age or a reading of 120/80 mm Hg or more. Hypertension is
defined as blood pressure in the 95th percentile or higher
. In children, a
secondary cause of the hypertension is more frequent with the renal disease being the one most commonly
implicated. Primary hypertension is most often linked to being overweight and
It cannot be
over emphasized that hypertensive children should also be screened
for presence of other risk factors
for cardiovascular diseases, diabetes
and should undergo an ophthalmoscopic examination and echocardiography to
evaluate the status of their retinas and hearts.
mainly involves lifestyle changes, including weight loss for children who are
overweight or obese; eating a healthy and balanced diet, low in salt; following
a regular exercise regimen and physical activity; and avoiding smoking and
may become necessary in the presence of persistent hypertension, if it is
symptomatic, associated with diabetes, in the presence of organ damage or if
the hypertension is due to an underlying cause (secondary hypertension).
- Stephen D Cha; The Effects of
Hypertension on Cognitive Function in Children and Adolescents; International
Journal of Pediatrics 2012
- Madhu Sharma MD et al; The
Effects of Hypertension on Pediatric Brain; A Justifiable Concern; The
Lancet Neurology Volume 9, No.
9, p933-940, September 2010
- High Blood
Pressure in Children and Adolescents - (http://www.aafp.org/afp/2012/0401/p693.html)