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Blood Pressure and Cognitive Function in Children and Adolescents.

The prevalence of primary hypertension in children has increased significantly, in parallel with the childhood obesity epidemic. School screening studies reveal that the current prevalence of hypertension in the United States is 2% to 4% overall, and as high as 10% in children who are overweight; a remarkably high number given that ≈20% of adolescents in the United States are obese. This striking prevalence of primary hypertension has important implications for both the short-term development of target-organ damage (TOD) during youth itself and long-term development of premature hypertension-related morbidity. Youth with hypertension commonly manifest adverse target-organ effects on the heart and vasculature, including left ventricular hypertrophy, increased carotid thickness, and increased arterial stiffness. There is now emerging evidence for adverse effects on the brain as well in children with moderate hypertension, findings with significant implications for the impact of primary hypertension on cognition both during childhood and later in life. This review will summarize the growing evidence for an association between early life hypertension and lower cognition both in midlife and during childhood itself.