Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States

J Pediatr. 2003 Dec;143(6):720-4. doi: 10.1067/S0022-3476(03)00412-8.


Objective: To evaluate the relationship between elevated blood pressure (BP) and cognitive test performance in a nationally representative sample of children. Study design The National Health and Nutrition Examination Survey III provides cross-sectional data for children 6 to 16 years, including BP and cognitive test scores. Elevated BP was defined as systolic or diastolic BP >or=90th percentile. Cognitive tests were compared for children with elevated and normal BP. Linear regression was used to evaluate the relation between elevated BP and decreased test scores.

Results: Among the 5077 children, 3.4% had systolic BP >or=90th percentile and 1.6% diastolic BP >or=90th percentile. Children with elevated systolic BP had lower average scores compared with normotensive children for digit span (7.9 vs 8.7, P=.01), block design (8.6 vs 9.5, P=.03), and mathematics (89.6 vs 93.8, P=.01). Elevated diastolic BP was associated with lower average scores on block design (9.5 vs 11, P=.01). Linear regression showed that elevated systolic BP was independently associated with lower digit span scores (P=.032).

Conclusion: Children with elevation of systolic BP are at risk for central nervous system end-organ damage, as manifested by decreased digit span test scores.

MeSH terms

  • Adolescent
  • Blood Pressure / physiology*
  • Child
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology*
  • Cognition Disorders / physiopathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Hypertension / physiopathology*
  • Male
  • Neuropsychological Tests
  • Nutrition Surveys
  • United States / epidemiology