Association of Psychosocial and Neurocognitive Dysfunction in Pediatric Hypertension
- Pediatric Nephrology - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
- Thiel, Vanessa, Nationwide Children's Hospital, Columbus, Ohio, United States
- Dawson, Anne E., Nationwide Children's Hospital, Columbus, Ohio, United States
- Kallash, Mahmoud, Nationwide Children's Hospital, Columbus, Ohio, United States
- Wilson, Camille, Nationwide Children's Hospital, Columbus, Ohio, United States
Pediatric hypertension (HTN) is a significant problem, with incidence of elevated BP increasing over time. Cardiac end organ damage of HTN is well-documented but only recently has attention turned to its neurocognitive effects. Researchers have previously demonstrated significantly lower performance on neurocognitive testing in children with primary HTN compared to normotensive controls and have reviewed the effects of HTN on attention and anxiety/depression. The goal of this study is to further identify the common neuropsychological concerns that are prevalent in children with HTN, and to clarify the neuropsychological factors associated with HTN concerns.
This is a retrospective chart review of outpatient pediatric nephrology patients (n=197) who received an ambulatory blood pressure monitor and neuropsychological screening measures between 6/2020 and 8/2021.
The study included 197 subjects who completed ABPM placement and neuropsychological screening. There was no specific correlation between ABPM data and clinical levels of anxiety, depression, or ADHD hyperactivity symptoms. HTN and ADHD inattentive symptoms were significantly associated. Elevated systolic BP load, elevated diastolic BP load, and mean arterial pressure were all associated with areas of executive functioning and learning concerns, inclusive of working memory and mathematics skills (all p’s <0.05). Systolic BP load was also associated with problems in factual memory, sequential processing, and problem-solving.
This study highlights the relation between pediatric HTN and neurocognitive concerns, but does not clarify concerns for psychological symptoms. The findings assert the potential need to implement behavioral health and neurocognitive screenings when concerns for elevated BP are present to activate immediate and effective intervention for BP management. Further analysis will continue to characterize specific aspects of HTN, patient demographics, and neuro/psychological symptom elevations.