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.

中文翻译：

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青少年收缩压、心血管健康和神经认知。


背景 我们研究了由听诊 SBP、动态 SBP 和心血管健康风险指标数量确定的收缩压 （SBP） 升高是否与青少年的神经认知相关。方法 这项横断面研究包括来自美国 365 个学术医疗中心的 15.5 名青少年 （平均年龄，6 岁）。样本为 59.5% 的男性，52.6% 的白人，23.9% 的护理人员具有低于或等于高中学位。主要暴露包括以下内容：听诊 SBP、动态 SBP 和心血管危险因素的数量。神经认知结果包括非语言智商、注意力和父母对执行功能的评分。结果 在检查了目标协变量 （例如，母亲教育程度） 的影响模型后，较高的听诊 SBP 与较低的非语言 IQ 相关 （β=-1.39;P<0.001） 和语言注意力 （β=-2.39;P<0.05）;高级动态 24 小时。收缩率 （β=-21.39;P<0.05） 和唤醒 SBP （β=-21.62;P<0.05） 与言语注意有关;所有 3 项动态血压测量都与持续注意力相关，占中小方差 （校正 R2=0.08-0.09）。较高的动态血压睡眠 SBP 也与父母的行为调节评分显著相关 （β=12.61;P<0.05）。在敏感性分析剔除高血压病例后，这些关联保持稳定。心血管危险因素的数量表现相似，更多的危险因素与较低的非语言智商相关 （β=-1.35;P<0.01）、言语注意 （β=-1.23;P<0.01） 以及执行功能的所有父评级。 结论 升高的 SBP，甚至低于高血压范围，以及一般心血管健康与青少年的神经认知结果相关。这些发现如何指导临床护理值得进一步研究。