Primary hypertension puts kids at risk for learning and attention problems, according to a 8 November online report in Paediatrics.
"Our study underscores the importance of recognising hypertension in children," Dr Marc B. Lande from University of Rochester Medical Centre, New York, told. "Despite the fact that about 4% of US children and adolescents have hypertension, studies show that the majority of cases go undiagnosed. Hopefully work such as ours will lead to increased awareness and therefore better diagnosis and management of associated learning problems."
Dr Lande and colleagues reviewed data on 201 patients ages 10 to 18 years, including 100 with hypertension.
Nine children without hypertension had learning disorders, compared with 28 children with hypertension (p<0.001). Seven children without hypertension were receiving treatment for attention deficit/hyperactivity disorder (ADHD), compared with 20 children with hypertension (p=0.007).
In multivariate analysis, children with hypertension were 4.1 times more likely than children without hypertension to have learning disorders. The increased likelihood did not change meaningfully when only children who were not being treated for ADHD were considered.
"The fact that the prevalence of learning disorders among subjects with hypertension was similar even among subjects who were not receiving medication for ADHD suggests that the association between learning disorders and hypertension was not an artifact of stimulant medication increasing blood pressure, and thereby biasing the results toward hypertension for the subjects with learning disorders," the researchers point out.
Hypertension and cognitive function
"Our next study, which actually began earlier this year, is focusing more closely on the relationship between hypertension and cognitive function," co-author Dr Heather R. Adams told.
The new study has several goals.
"The first goal is to confirm a finding from our prior studies - that children with hypertension perform less well on tests of executive function in comparison to children without hypertension," Adams said. "In addition, we will look at whether there is a 'dose-response' relationship between the severity of blood pressure elevations and cognitive problems."
"Finally," she said, "we will examine whether there is a relationship between cognitive function and cardiovascular target organ damage. If so, it would help us to understand the potential biological mechanisms underlying cognitive function changes in hypertensive children."
"We want physicians to be aware that hypertension is a growing problem in children," Dr Adams concluded. "Physicians play a very important role not only in the immediate treatment and prevention of hypertension, but also in improving children's long-term health, and in screening for learning problems that can have an everyday impact on children's school function." (Reuters Health/ November 2010)
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