U. ROCHESTER (US)—The long list of health problems associated with hypertension and obesity in children continues to grow—as do the number of newly diagnosed cases each year. A study out of the University of Rochester is adding to that list of associated symptoms and raising red flags for parents and doctors.
Children with high blood are more likely to have memory problems, to struggle to complete complicated tasks, and even to have difficulty planning ahead, according to the new findings. The study, however, also shows that the cognitive problems tend to disappear when the hypertension is brought under control. The results could give physicians and parents more impetus to diagnose and treat high blood pressure in children, a condition that could become more common as obesity rates rise nationwide.
Marc Lande, a pediatric nephrologist at the University of Rochester’s Golisano Children’s Hospital and author of the study, says the results surprised him. “Adults with hypertension often have other problems that might affect cognition such as chronic disease, smoking, or alcohol use. However, children with hypertension usually do not have these comorbidities.”
In adults, high blood pressure can lead to a long and dangerous list of health issues, including stroke, heart disease, heart attack, heart failure, and kidney failure. Lande believes the cognitive changes he observed may represent very early manifestations of hypertensive damage to the brain, which may long precede more overt damage such as stroke.
Because more than half the children with both hypertension and obesity demonstrated clinically significant anxiety and depression, Lande says he was initially trying to rule out those conditions as source of the cognitive difficulty. He did not expect to tease out this new finding.
“Children with only obesity or only hypertension did not have the anxiety and depression that children with both obesity and hypertension did,” Lande notes. “With further study, screening for anxiety and depression could end up being routine when an obese child is diagnosed with hypertension.”
Lande was inspired to conduct the study after finding a correlation between high blood pressure and lower scores on neurocognitive tests in a nationally representative dataset, NHANES III, the National Health and Nutrition Examination Survey conducted from 1988 to 1994. To dig deeper, Lande enrolled 32 newly diagnosed hypertensive children and adolescents (10 to 18 years old) from the Pediatric Hypertension Clinic at the University’s Golisano Children’s Hospital. Children who didn’t have sustained hypertension or had previous medical issues that affected learning or sleeping were excluded. Thirty-two children with normal blood pressure were recruited from the hospital’s pediatric practice and other area pediatric practices and were matched with the hypertensive children by age, weight, sex, race IQ, and socioeconomic level.
The parents of both sets of 32 children answered a series of surveys to determine their children’s executive function. (Testing the children through parental assessments can be a more valid test because these assessments evaluate the child’s abilities in real-life situations better than directly testing a child, one-on-one in a lab setting) Although the hypertensive group did not perform poorly enough to require clinical intervention, the results were significantly different than the group without hypertension.
Lande says that while the long-term implications of these subtle changes are not clear, “the potential for these differences in cognitive function to affect children is certainly concerning enough to warrant further study.”
University of Rochester news: www.rochester.edu/news