Children with high blood pressure are four times more likely to have learning problems than the average child, according to a new University of Rochester Medical Center (URMC) study.
“This study also found that children with hypertension are more likely to have ADHD (attention deficit hyperactivity disorder),” said Heather R. Adams, Ph.D., assistant professor of neurology and pediatrics at URMC, and an author of the study.
“Although retrospective, this work adds to the growing evidence of an association between hypertension and cognitive function. With 4 percent of children now estimated to have hypertension, the need to understand this potential connection is incredibly important.”
The study included 201 children between the ages of 10 and 18 who had been referred to a pediatric hypertension clinic at URMC’s Golisano Children’s Hospital. Of these, 101 had actual hypertension, or sustained high blood pressure, that was determined by 24-hour ambulatory monitoring or had been monitored by a school nurse or at home.
Among all of the study participants, 18 percent had learning problems, which is far higher than the general population’s rate of five percent. However, the children with hypertension were the significant factor for pulling such high numbers, as 28 percent of these had a learning disability; the rest of the participants without hypertension came in at about nine percent. The children’s learning disabilities and ADHD diagnoses were reported by parents.
This research was part of a series of hypertension studies led by pediatric nephrologist Marc Lande, M.D., but it was the first to include children with ADHD, because ADHD medications can increase blood pressure.
In this case, however, ADHD children were included because, even if the medications cause some of the hypertension, there is also the possibility that that the higher rate of ADHD symptoms in children with high blood pressure is a reflection of neurocognitive problems caused by hypertension.
Among the study participants, 20 percent of the children with hypertension had ADHD, but only seven percent of those without hypertension had ADHD. Furthermore, when ADHD was factored out of the analyses, there was still a higher rate of cognitive problems in the children with hypertension, compared to those without it.
“With each study, we’re getting closer to understanding the relationship between hypertension and cognitive function in children,” Lande said.
“And this study underscores the need for us to continue to tease out the potential risk children with hypertension have for learning difficulties at a time when learning is so important. It may be too early to definitively link hypertension and learning disabilities, but it isn’t too early for us, as clinicians, to ensure our pediatric patients with hypertension are getting properly screened for cognitive issues.”
This study is published in the journal Pediatrics and was funded by a grant from the National Institutes of Health.