Systolic Blood Pressure, Cardiovascular Health, and Neurocognitive in Adolescents.

Autor:	Hooper SR; University of North Carolina-Chapel Hill (S.R.H.)., Lande MB; University of Rochester Medical Center (M.B.L.)., Flynn JT; Department of Pediatrics, University of Washington School of Medicine, and Division of Nephrology, Seattle Children's Hospital (J.T.F., C.D.H.)., Hanevold CD; Department of Pediatrics, University of Washington School of Medicine, and Division of Nephrology, Seattle Children's Hospital (J.T.F., C.D.H.)., Meyers KE; Children's Hospital of Philadelphia and University of Pennsylvania (K.E.M.)., Samuels J; McGovern Medical School at University of Texas Health and Children's Memorial Hermann Hospital, Houston (J. Samuels)., Becker RC; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.)., Daniels SR; Children's Hospital Colorado, Denver (S.R.D.)., Falkner BE; Thomas Jefferson University, Philadelphia, PA (B.E.F.)., Ferguson MA; Boston Children's Hospital (M.A.F.)., Ingelfinger JR; Massachusetts General Hospital, Boston (J.R.I.)., Martin LJ; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.)., Mitsnefes M; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.)., Khoury P; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.)., Seo J; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.)., Urbina EM; Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine (R.C.B., L.J.M., M.M., P.K., J. Seo, E.M.U.).
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2024 Sep 18. Date of Electronic Publication: 2024 Sep 18.
DOI:	10.1161/HYPERTENSIONAHA.124.22834
Abstrakt:	Background: We studied whether increased systolic blood pressure (SBP), as determined by auscultatory SBP, ambulatory SBP, and the number of cardiovascular health risk indicators, are associated with neurocognition in adolescents. Methods: This cross-sectional study included 365 adolescents (mean age, 15.5 years) from 6 academic medical centers in the United States. The sample was 59.5% male, 52.6% White, with 23.9% of the caregivers having less than or equal to a high school degree. Primary exposures included the following: auscultatory SBP, ambulatory SBP, and the number of cardiovascular risk factors. Neurocognitive outcomes comprised nonverbal IQ, attention, and parent ratings of executive functions. Results: After examining the models for the effects of targeted covariates (eg, maternal education), higher auscultatory SBP was associated with lower nonverbal IQ (β=-1.39; P <0.001) and verbal attention (β=-2.39; P <0.05); higher ambulatory 24 hours. SBP (β=-21.39; P <0.05) and wake SBP (β=-21.62; P <0.05) were related to verbal attention; and all 3 ambulatory blood pressure measures were related to sustained attention accounting for small to medium amounts of variance (adjusted R 2 =0.08-0.09). Higher ambulatory blood pressure sleep SBP also was significantly associated with parent ratings of behavior regulation (β=12.61; P <0.05). These associations remained stable after a sensitivity analysis removed cases with hypertension. Number of cardiovascular risk factors performed similarly, with more risk factors being associated with lower nonverbal IQ (β=-1.35; P <0.01), verbal attention (β=-1.23; P <0.01), and all parent ratings of executive functions. Conclusions: Elevated SBP, even below the hypertension range, and general cardiovascular health are associated with neurocognitive outcomes in adolescents. How these findings might guide clinical care is worthy of additional study.
Databáze:	MEDLINE
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