Young hypertensive adults have been reported to have worse performance on neurocognitive testing compared with normotensives. The objective of the present study was to assess the potential early effects of hypertension on the brain in children by evaluating neurocognitive test performance.Design and method:
We evaluated executive function in hypertensive children compared to normotensive ones in a cross-sectional study. All children and adolescents included in the study underwent ambulatory blood pressure monitoring. Hypertension was defined as daytime and/or nighttime BP greater than the 95th percentile for sex and height. BP index was calculated as mean BP divided by the 95th BP pc specific for each child. To evaluate executive function parents completed the Behavior Rating Inventory of Executive Function (BRIEF), a rating scale that evaluates different aspects of executive function behaviors in the home environment during child's everyday life.Results:
The study population included 38 children, aged 12.18 ± 3.26 years, 47.4% boys. Fifty % of the children had hypertension (88% secondary causes). Hypertensive children compared to normotensives had higher T scores (52.00 ± 9.42 vs. 39.94 ± 11.63, p < 0.05) and percentiles (60.82 ± 25.31 vs. 30.17 ± 25.98, p < 0.001) in the clinical scale of organization of materials. The statistically significant differences persisted after adjustment for age, sex, and e-GFR. When daytime and nighttime hypertension were examined separately children with nighttime, but not those with daytime hypertension presented significantly higher values in T scores and percentiles for organization of materials. BP elevation expressed by BP index presented significant correlations with BRIEF scales after adjustment for e-GFR, hemoglobin levels, age and sex. Systolic daytime and nighttime BP index correlated with monitor percentile (r = 0.72, p < 0.01, and r = 0.66, P < 0.05, respectively), while diastolic daytime BP index correlated with both monitor percentile and organization of materials percentile (r = 0.64, p < 0.05 and r = 0.63, p < 0.05, respectively).Conclusions:
BRIEF scores were higher in the hypertensive children suggesting worse executive function compared with the normotensives subjects. Correlations of BRIEF scales with BP measures occurred even within the normal limits of the rating scale implying that early effect of BP on the brain may occur within the normal range of the neurocognitive measures.