Executive function and cerebrovascular reactivity in pediatric hypertension

J Child Neurol. 2015 Apr;30(5):543-6. doi: 10.1177/0883073813494264. Epub 2013 Jul 22.

Abstract

Primary hypertension is associated with decreased performance on neurocognitive testing and a blunted cerebrovascular reactivity to hypercapnia. Parents of 14 children with hypertension and prehypertension completed the Behavior Rating Inventory of Executive Functions. Children underwent 24-hour ambulatory blood pressure monitoring and transcranial Doppler with reactivity measurement using time-averaged maximum mean velocity and end-tidal carbon dioxide during hypercapnia-rebreathing test. Comparing the reactivity slope for the patients to historical controls showed a statistically significant difference (t = -5.19, df = 13, P < .001), with lower slopes. Pearson correlations of the Behavior Rating Inventory of Executive Functions scores with the reactivity slopes showed a statistically significant inverse relationship with Behavioral Regulation Index (r = -.60, P = .02), Metacognition Index (r = -.40, P = .05), and the Global Executive Component (r = -.53, P = .05). Children with hypertension have decreased executive function, and this correlates to low transcranial Doppler-reactivity slopes, suggesting that the brain is a target organ in hypertensive children.

Keywords: cognition; hypertension; transcranial Doppler.

MeSH terms

  • Adolescent
  • Blood Flow Velocity
  • Blood Pressure Monitoring, Ambulatory
  • Brain / physiopathology
  • Carbon Dioxide / metabolism
  • Child
  • Executive Function* / physiology
  • Female
  • Humans
  • Hypercapnia / physiopathology
  • Hypertension / diagnostic imaging
  • Hypertension / physiopathology*
  • Hypertension / psychology*
  • Linear Models
  • Male
  • Psychological Tests
  • Ultrasonography, Doppler, Transcranial

Substances

  • Carbon Dioxide