Systolic Blood Pressure, Cardiovascular Health, and Neurocognition in Adolescents.

Authors

• Stephen R Hooper
• Marc B Lande
• Joseph T Flynn
• Coral D Hanevold
• Kevin E Meyers
• Joshua Samuels
• Richard C Becker
• Stephen R Daniels
• Bonita E Falkner
• Michael A Ferguson
• Julie R Ingelfinger
• Lisa J Martin
• Mark Mitsnefes
• Phillip Khoury
• Jangdong Seo
• Elaine M Urbina

Language

English

Publication Date

12-1-2024

Journal

Hypertension

DOI

10.1161/HYPERTENSIONAHA.124.22834

PMID

39291378

PMCID

PMC11578784

PubMedCentral® Posted Date

12-1-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: We studied whether increased systolic blood pressure (SBP), as determined by auscultatory SBP, ambulatory SBP, and the number of cardiovascular health risk indicators, are associated with neurocognition in adolescents.

Methods: This cross-sectional study included 365 adolescents (mean age, 15.5 years) from 6 academic medical centers in the United States. The sample was 59.5% male, 52.6% White, with 23.9% of the caregivers having less than or equal to a high school degree. Primary exposures included the following: auscultatory SBP, ambulatory SBP, and the number of cardiovascular risk factors. Neurocognitive outcomes comprised nonverbal IQ, attention, and parent ratings of executive functions.

Results: After examining the models for the effects of targeted covariates (eg, maternal education), higher auscultatory SBP was associated with lower nonverbal IQ (β=-1.39; P< 0.001) and verbal attention (β=-2.39; P< 0.05); higher ambulatory 24 hours. SBP (β=-21.39; P< 0.05) and wake SBP (β=-21.62; P< 0.05) were related to verbal attention; and all 3 ambulatory blood pressure measures were related to sustained attention accounting for small to medium amounts of variance (adjusted R2=0.08-0.09). Higher ambulatory blood pressure sleep SBP also was significantly associated with parent ratings of behavior regulation (β=12.61; P< 0.05). These associations remained stable after a sensitivity analysis removed cases with hypertension. Number of cardiovascular risk factors performed similarly, with more risk factors being associated with lower nonverbal IQ (β=-1.35; P< 0.01), verbal attention (β=-1.23; P< 0.01), and all parent ratings of executive functions.

Conclusions: Elevated SBP, even below the hypertension range, and general cardiovascular health are associated with neurocognitive outcomes in adolescents. How these findings might guide clinical care is worthy of additional study.

Keywords

Humans, Male, Female, Adolescent, Cross-Sectional Studies, Blood Pressure, Hypertension, Executive Function, Blood Pressure Monitoring, Ambulatory, Cardiovascular Diseases, United States, Cognition, Heart Disease Risk Factors, Risk Factors, Attention, Systole, SHIP-AHOY Study, Auscultatory Blood Pressure, Ambulatory Blood Pressure, Cardiovascular Health Risk, Neurocognition, Adolescence

Published Open-Access

yes

Recommended Citation

Hooper, Stephen R; Lande, Marc B; Flynn, Joseph T; et al., "Systolic Blood Pressure, Cardiovascular Health, and Neurocognition in Adolescents." (2024). Faculty, Staff and Student Publications. 4272.
https://digitalcommons.library.tmc.edu/uthmed_docs/4272