Parental Assessment of Executive Function and Internalizing and Externalizing Behavior in Primary Hypertension after Anti-Hypertensive Therapy

• Published in: The Journal of pediatrics Vol. 157; no. 1; pp. 114 - 119
• Main Authors: Lande, Marc B., MD, MPH, Adams, Heather, PhD, Falkner, Bonita, MD, Waldstein, Shari R., PhD, Schwartz, George J., MD, Szilagyi, Peter G., MD, MPH, Wang, Hongyue, PhD, Palumbo, Donna, PhD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.07.2010; Elsevier
• Subjects: Adolescent; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - drug effects; Cardiology. Vascular system; Case-Control Studies; Checklist; Executive Function; Female; Follow-Up Studies; General aspects; Humans; Hypertension - drug therapy; Hypertension - psychology; Internal-External Control; Male; Medical sciences; Parents; Pediatrics; Surveys and Questionnaires; Time Factors; Treatment Outcome; ABPM; SBP; Systolic blood pressure; Child Behavior Checklist; GEC; Diastolic blood pressure; BP; Ambulatory blood pressure monitoring; BRIEF; Behavior Rating Inventory of Executive Function; Metacognition Index; CBCL; DPB; Left ventricular hypertrophy; BRI; Blood pressure; MI; Behavior Regulation Index; Global Executive Composite; LVH; Hypertension; Pediatrics; Executive function; Treatment; Parent rating; Primary; Cardiovascular disease; Behavioral disorder
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2009.12.053

Objective To determine the change in parental ratings of executive function and behavior in children with primary hypertension after anti-hypertensive therapy. Study design Parents of subjects with untreated hypertension and control subjects completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess behavioral correlates of executive function and the Child Behavior Checklist (CBCL) to assess internalizing and externalizing behaviors. Subjects with hypertension subsequently received anti-hypertensive therapy to achieve casual blood pressure (BP) <95th percentile. After 12 months, all parents again completed the BRIEF and CBCL. Results Twenty-two subjects with hypertension and 25 normotensive control subjects underwent both baseline and 12-month assessments. The BP of subjects with hypertension improved (24-hour systolic BP [SBP] load: mean baseline versus 12-months, 60% versus 25%, P < .001). Parent ratings of executive function improved from baseline to 12 months in the subjects with hypertension (BRIEF Global Executive Composite T-score, Δ = –5.9, P = 0.001), but not in the normotensive control subjects (Δ = –0.36, P = .83). In contrast, T-scores on the CBCL Internalizing and Externalizing summary scales did not change significantly from baseline to 12 months in either subjects with hypertension or control subjects. Conclusions Children with hypertension demonstrated improvement in parental ratings of executive function after 12 months of anti-hypertensive therapy.