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However, its role in early childhood remains unclear. We examined the relationship between blood pressure (BP), LV structure, and cognitive function in preschool-aged children. This population is free from aging-related comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 1279 4-year-old children from the Shanghai Birth Cohort (2018\u20132021), excluding those with birth defects or developmental delays. BP and echocardiographic assessment were conducted at follow-up. Cognitive function was evaluated using the Wechsler preschool and primary scales of intelligence-fourth edition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elevated BP (107.4\u2009\u00b1\u20096.2\u00a0mmHg) compared to normal BP (96.0\u2009\u00b1\u20095.9\u00a0mmHg) tended towards lower full scale intelligence quotient (IQ) [adjusted mean difference (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      )\u2009=\u2009\u2212\u00a02.95, 95% confidence interval (CI)\u00a0= \u2212\u00a04.65, \u2212\u00a01.25], processing speed index (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a01.77, 95% CI\u00a0= \u2212\u00a03.41, \u2212\u00a00.14), working memory index (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a02.79, 95% CI\u00a0= \u2212\u00a04.70, \u2212\u00a00.88) and visual spatial index (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a02.64, 95% CI\u00a0= \u2212\u00a04.74, \u2212\u00a00.55). These associations persisted after adjusting for LV mass index (LVMI). Higher systolic BP, analyzed as a continuous variable, was associated with lower full scale IQ (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a00.12, 95% CI\u00a0= \u2212\u00a00.21, \u2212\u00a00.03) and visual spatial index (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u00a00.23, 95% CI\u00a0= \u2212\u00a00.35, \u2212\u00a00.10); diastolic BP showed the same trend. There was no significant association between cognitive function and LV structure or the mediating effect of LVMI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher BP was associated with poorer cognitive development as early as age four; LV structural alterations were not. This suggests that the relationship between BP and cognitive function was independent of LVMI in early childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12519-026-01078-7","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T14:17:00Z","timestamp":1786717020000},"page":"782-792","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood pressure, left ventricular structure and cognitive development in young children: a cross-sectional study"],"prefix":"10.1007","volume":"22","author":[{"given":"Hua-Lin","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Wen","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo-Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian-Chuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai-Fang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Kang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7646-669X","authenticated-orcid":false,"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"1078_CR1","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/s0140-6736(96)90608-x","volume":"347","author":"I Skoog","year":"1996","unstructured":"Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, et al. 15-year longitudinal study of blood pressure and dementia. 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Kun Sun is an Associate Editor for\n                      World Journal of Pediatrics\n                      . This paper was handled independently and has undergone rigorous peer review. Kun Sun was not involved in the review of or decisions related to this manuscript.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was granted by the Ethics Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (No. XHEC-C-2013-001-2). Written informed consent to participate in the study was obtained from the parent or legal guardian of each enrolled child.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}