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Learning and attention problems among children with pediatric primary hypertension.

ABSTRACT: 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.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).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]).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.

SUBMITTER: Adams HR

PROVIDER: S-EPMC5578423 | biostudies-other | 2010 Dec

REPOSITORIES: biostudies-other

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Learning and attention problems among children with pediatric primary hypertension.

Adams Heather R HR Szilagyi Peter G PG Gebhardt Laura L Lande Marc B MB

Pediatrics 20101108 6

<h4>Objective</h4>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.<h4>Methods</h4>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 subseque ...[more]

PMID: 21059718

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Project description:RationalePediatric pulmonary hypertension (PH) is a heterogeneous condition with varying natural history and therapeutic response. Precise classification of PH subtypes is, therefore, crucial for individualizing care. However, gaps remain in our understanding of the spectrum of PH in children.ObjectiveWe seek to study the manifestations of PH in children and to assess the feasibility of applying a network-based approach to discern disease subtypes from comorbidity data recorded in longitudinal data sets.Methods and resultsA retrospective cohort study comprising 6 943 263 children (<18 years of age) enrolled in a commercial health insurance plan in the United States, between January 2010 and May 2013. A total of 1583 (0.02%) children met the criteria for PH. We identified comorbidities significantly associated with PH compared with the general population of children without PH. A Bayesian comorbidity network was constructed to model the interdependencies of these comorbidities, and network-clustering analysis was applied to derive disease subtypes comprising subgraphs of highly connected comorbid conditions. A total of 186 comorbidities were found to be significantly associated with PH. Network analysis of comorbidity patterns captured most of the major PH subtypes with known pathological basis defined by the World Health Organization and Panama classifications. The analysis further identified many subtypes documented in only a few case studies, including rare subtypes associated with several well-described genetic syndromes.ConclusionsApplication of network science to model comorbidity patterns recorded in longitudinal data sets can facilitate the discovery of disease subtypes. Our analysis relearned established subtypes, thus validating the approach, and identified rare subtypes that are difficult to discern through clinical observations, providing impetus for deeper investigation of the disease subtypes that will enrich current disease classifications.

Dataset Information

Learning and attention problems among children with pediatric primary hypertension.

Publications

Learning and attention problems among children with pediatric primary hypertension.

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