Hubungan Tekanan Darah dengan Fungsi Kognitif pada Remaja

Abstract

Background: The prevalence of hypertension is increasing in childhood and usually asymptomatic but still has target organ damage manifestations. This condition may cause negative impacts on their cognitive function. Early detection and appropriate management on hypertension may lessen cognitive impairment associated with hypertension. Objective: To determine the relationship between hypertension to cognitive function in adolescent. Methods: A cross sectional study was conducted among 193 children aged 12 to 17 years in Singkuang Village, Mandailing Natal Regency, North Sumatera on April 2016. Blood pressure and cognitive test scores were collected. Hypertension was defined as systolic or diastolic blood pressure at ≥95th percentile according to The Fourth Report from the National High Blood Pressure Education Program Working Group on Children and Adolescent. Cognitive impairment was defined as borderline and lower cognitive test scores. Chi-square test was used to analyze the association between hypertension and cognitive function. The P value of <0.05 at 95% confidence interval (CI) was considered significant. Results: Of 193 adolescents, 28% had hypertension. Adolescents with hypertension had lower Intelligence Quotient (IQ) scores compared with normotensive adolescents for verbal (P=0.008; PR=2.381; CI=1.244 – 4.559), performance (P=0.021; PR=2.134; CI=1.115 – 4.082), and full scale domain (P=0.005; PR=2.475; CI=1.295 – 4.730). Conclusion: There is a significant association between hypertension and cognitive function in adolescents.

Latar Belakang : Prevalensi hipertensi meningkat pada usia remaja yang biasanya asimptomatik namun memiliki manifestasi kerusakan pada organ. Hal ini mengakibatkan dampak buruk terhadap fungsi kognitif. Deteksi awal dan tatalaksana yang tepat terhadap hipertensi dapat mengurangi penurunan fungsi kognitif akibat hipertensi. Tujuan: Untuk mengetahui hubungan antara hipertensi terhadap fungsi kognitif pada remaja. Metode: Penelitian ini dilakukan secara cross-sectional, yang dilakukan di desa Singkuang, Kecamatan Mandailing Natal, Propinsi Sumatera Utara pada bulan April 2016. Subjek penelitian ini adalah 193 remaja berusia 12 – 17 tahun yang bersekolah di SMP. Data tekanan darah dan tes fungsi kognitif dilakukan secara langsung terhadap subjek penelitian. Hipertensi didefinisikan jika tekanan darah sistol dan diastol ≥ persentil 95 berdasarkan The Fourth Report from the National High Blood Pressure Education Program Working Group on Children and Adolescent. Penurunan fungsi kognitif didefinisikan jika skor tes dibawah nilai normal. Data dianalisa dengan menggunakan uji Chi-square, nilai signifikan bila p < 0,05 dan interval kepercayaan 95%. Hasil: Dari 193 remaja, terdapat 28% remaja yang menderita hipertensi. Remaja dengan hipertensi memiliki skor IQ yang lebih rendah dibandingkan remaja dengan normotensi, dengan fungsi kognitif domain verbal (P=0.008; RP=2.381; IK=1.244 – 4.559), domain performance (P=0.021; RP=2.134; IK=1.115 – 4.082), dan full scale (P=0.005; PR=2.475; CI=1.295 – 4.730). Kesimpulan: Hipertensi meningkatkan risiko penurunan fungsi kognitif pada remaja.