Learning and Attention Problems Among Children With Pediatric Primary Hypertension

OBJECTIVE: The objective was to determine whether children with sustained primary hypertension are at increased risk for learning disabilities (LDs), as a school-related manifestation of neurocognitive problems. METHODS: A total of 201 children 10 to 18 years of age who were referred because of elevated blood pressure (BP) were included. Patients were categorized as having or not having hypertension, on the basis of BP evaluation at the initial hypertension clinic visit and subsequent confirmation of sustained elevated BP outside the clinic setting. Parents reported whether their child had a provider-confirmed LD or attention-deficit/hyperactivity disorder (ADHD). RESULTS: A total of 101 children without hypertension and 100 children with hypertension were evaluated; 18% of the children (n = 37) had LDs. In comparison with children without hypertension, children with hypertension were significantly more likely to have LDs (18% vs 9%; P < .001), irrespective of comorbid ADHD. With adjustment for demographic variables and obesity, the odds of having LDs were elevated for subjects with hypertension, in comparison with subjects without hypertension (odds ratio: 4.1 [95% confidence interval: 1.8-9.4]). CONCLUSIONS: The rate of LDs, with or without ADHD treatment, was significantly higher for children with sustained primary hypertension, compared with children without hypertension. These findings add to the growing evidence for an association between primary hypertension and cognitive function and may inform treatment and monitoring decisions for these children who may be at risk for learning problems. Pediatrics 2010;126:e1425-e1429