title: Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States.
abstract: OBJECTIVE
  To evaluate the relationship between elevated blood pressure (BP) and cognitive test performance in a nationally representative sample of children. Study design The National Health and Nutrition Examination Survey III provides cross-sectional data for children 6 to 16 years, including BP and cognitive test scores. Elevated BP was defined as systolic or diastolic BP >or=90th percentile. Cognitive tests were compared for children with elevated and normal BP. Linear regression was used to evaluate the relation between elevated BP and decreased test scores.
  
  
  RESULTS
  Among the 5077 children, 3.4% had systolic BP >or=90th percentile and 1.6% diastolic BP >or=90th percentile. Children with elevated systolic BP had lower average scores compared with normotensive children for digit span (7.9 vs 8.7, P=.01), block design (8.6 vs 9.5, P=.03), and mathematics (89.6 vs 93.8, P=.01). Elevated diastolic BP was associated with lower average scores on block design (9.5 vs 11, P=.01). Linear regression showed that elevated systolic BP was independently associated with lower digit span scores (P=.032).
  
  
  CONCLUSIONS
  Children with elevation of systolic BP are at risk for central nervous system end-organ damage, as manifested by decreased digit span test scores.
authors.affiliation: Golisano Children's Hospital at Strong, Department of Pediatrics, University of Rochester, Rochester, New York 14642, USA. marc_lande@urmc.rochester.edu
authors.forename: Marc B
authors.initials: MB
authors.lastname: Lande
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Kaczorowski
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
authors.forename: George J
authors.initials: GJ
authors.lastname: Schwartz
authors.forename: Michael
authors.initials: M
authors.lastname: Weitzman
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D009483:Neuropsychological Tests; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology