Juan C Kupferman1, Donald L Batisky2, Joshua Samuels3, Heather R Adams4, Stephen R Hooper5, Hongyue Wang6, Marc B Lande7. 1. Department of Pediatrics, Maimonides Medical Center, 977 48th Street, Brooklyn, NY, 11219, USA. Jkupferman@maimonidesmed.org. 2. Department of Pediatrics, Emory University, Atlanta, GA, USA. 3. Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, USA. 4. Department of Neurology, University of Rochester, Rochester, NY, USA. 5. Departments of Allied Health Sciences and Psychiatry, University of North Carolina, Chapel Hill, NC, USA. 6. Department of Biostatistics, University of Rochester, Rochester, NY, USA. 7. Department of Pediatrics, University of Rochester, Rochester, NY, USA.
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.
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.
Authors: Juan C Kupferman; Kara Paterno; Joseph Mahgerefteh; Murali Pagala; Meg Golden; Irene D Lytrivi; Prema Ramaswamy Journal: Pediatr Nephrol Date: 2010-08 Impact factor: 3.714
Authors: Marc B Lande; Heather R Adams; Juan C Kupferman; Stephen R Hooper; Peter G Szilagyi; Donald L Batisky Journal: J Am Soc Hypertens Date: 2013-06-20
Authors: Sarah L Stevens; Sally Wood; Constantinos Koshiaris; Kathryn Law; Paul Glasziou; Richard J Stevens; Richard J McManus Journal: BMJ Date: 2016-08-09