Lande Marc B, Batisky Donald L, Kupferman Juan C, Samuels Joshua, Hooper Stephen R, Falkner Bonita, Waldstein Shari R, Szilagyi Peter G, Wang Hongyue, Staskiewicz Jennifer, Adams Heather R
Department of Pediatrics, University of Rochester, Rochester, NY.
Department of Pediatrics, Emory University, Atlanta, GA.
J Pediatr. 2017 Jan;180:148-155.e1. doi: 10.1016/j.jpeds.2016.08.076. Epub 2016 Sep 29.
To compare neurocognitive test performance of children with primary hypertension with that of normotensive controls.
Seventy-five children (10-18 years of age) with newly diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed. Parents completed rating scales of executive function and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ-SRBD).
Hypertension and control groups did not differ significantly in age, sex, maternal education, income, race, ethnicity, obesity, anxiety, depression, cholesterol, glucose, insulin, and C-reactive protein. Subjects with hypertension had greater PSQ-SRBD scores (P = .04) and triglycerides (P = .037). Multivariate analyses showed that hypertension was independently associated with worse performance on the Rey Auditory Verbal Learning Test (List A Trial 1, P = .034; List A Total, P = .009; Short delay recall, P = .013), CogState Groton Maze Learning Test delayed recall (P = .002), Grooved Pegboard dominant hand (P = .045), and Wechsler Abbreviated Scales of Intelligence Vocabulary (P = .016). Results indicated a significant interaction between disordered sleep (PSQ-SRBD score) and hypertension on ratings of executive function (P = .04), such that hypertension heightened the association between increased disordered sleep and worse executive function.
Youth with primary hypertension demonstrated significantly lower performance on neurocognitive testing compared with normotensive controls, in particular, on measures of memory, attention, and executive functions.
比较原发性高血压儿童与血压正常对照组儿童的神经认知测试表现。
75名新诊断的、未经治疗的高血压儿童（10 - 18岁）和75名频率匹配的血压正常对照组儿童进行了基线神经认知测试，这是一项关于原发性高血压认知的前瞻性多中心研究的一部分。受试者完成了一般智力、注意力、记忆力、执行功能和处理速度的测试。家长完成了执行功能评定量表和儿童睡眠问卷的睡眠相关呼吸障碍量表（PSQ - SRBD）。
高血压组和对照组在年龄、性别、母亲教育程度、收入、种族、民族、肥胖、焦虑、抑郁、胆固醇、血糖、胰岛素和C反应蛋白方面无显著差异。高血压受试者的PSQ - SRBD评分（P = 0.04）和甘油三酯水平（P = 0.037）更高。多变量分析显示，高血压与雷伊听觉词语学习测试（表A试验1，P = 0.034；表A总分，P = 0.009；短延迟回忆，P = 0.013）、CogState格罗顿迷宫学习测试延迟回忆（P = 0.002）、槽式钉板优势手测试（P = 0.045）以及韦氏儿童智力量表简式版词汇测试（P = 0.016）的较差表现独立相关。结果表明，睡眠紊乱（PSQ - SRBD评分）与高血压在执行功能评分方面存在显著交互作用（P = 0.04），即高血压加剧了睡眠紊乱增加与执行功能较差之间的关联。
与血压正常对照组相比，原发性高血压青少年在神经认知测试中的表现显著较低，尤其是在记忆、注意力和执行功能测量方面。
