title: Executive function and cerebrovascular reactivity in pediatric hypertension.
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.
authors.affiliation: Center for Brain and Behavior, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ostrovskaya
authors.affiliation: Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Rojas
authors.affiliation: Division of Pediatric Nephrology and Hypertension, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Kupferman
authors.affiliation: Department of Pediatrics, University of Rochester Medical Center, Brooklyn, NY, USA.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Lande
authors.affiliation: Division of Pediatric Nephrology and Hypertension, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Paterno
authors.affiliation: Center for Brain and Behavior, Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Brosgol
authors.affiliation: Center for Brain and Behavior, Maimonides Medical Center, Brooklyn, NY, USA spavlakis@maimondesmed.org.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Pavlakis
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D018660:Blood Pressure Monitoring, Ambulatory; D001921:Brain / Q000503:physiopathology; D002245:Carbon Dioxide / Q000378:metabolism; D002648:Child; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D016014:Linear Models; D008297:Male; D011581:Psychological Tests; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D002245:Carbon Dioxide
keywords: cognition; hypertension; transcranial Doppler