Abstract: FR-PO551

Racial Disparities in Pediatric Hypertension Management

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Cates, Christopher, University of Missouri School of Medicine, Columbia, Missouri, United States
  • Crawford, Bethany, University of Missouri School of Medicine, Columbia, Missouri, United States
  • Lin, John, Washington University in St. Louis, St. Louis, Missouri, United States
  • Hoffman, Nichaela A, Barnes Jewish Hospital, St. Louis, Missouri, United States
  • Davis, Thomas K., Washington University School of Medicine, St Louis, Missouri, United States
  • Dharnidharka, Vikas R., Washington University School of Medicine, St Louis, Missouri, United States
  • Hesemann, Laura, University of Missouri School of Medicine, Columbia, Missouri, United States
Background

African American (AA) adults have a higher prevalence of HTN and lower rates of control when compared to non-Hispanic whites (non-AA). Evidence for a similar disparity in pediatric populations is mixed though there are differences in hypertension-related morbidity. Studies assessing differences in HTN control between ethnic groups are lacking for pediatric patients. The goal of this study was to evaluate rates of HTN control among pediatric patients of different ethnicity.

Methods

All patients with a diagnosis of HTN seen between May 2012 and April 2013 at a pediatric nephrology clinic in an academic center were evaluated. Patients with resolved HTN, ESRD, or history of kidney transplant were excluded. Blood pressure control was recorded as documented by the treating physician. Data were collected to evaluate risk factors for uncontrolled HTN, including race, age, gender, stage of HTN, number of medications, BMI, and presence of CKD.

Results

126 subjects were included. 41 (33%) identified as African American, 85 (67%) identified as Caucasian, Asian, or Other. Median age was 14 (range 5 months-20 years). Among all subjects, 83% were documented as having adequate BP control. However, the rate of control among AA subjects was 68% compared to 87% among non-AA subjects (p=0.012). When comparing racial groups, there was no difference in BMI group, CKD, family history, use of multiple anti-hypertensive medications, or stage of HTN.

Conclusion

In this pediatric cohort, AA subjects were less likely to have adequately-controlled blood pressure when compared to non-AA despite no difference in commonly-assessed risk factors for HTN or the number of medications prescribed. This parallels results obtained through population-based studies showing lower rates of blood pressure control among AA adults compared to non-AA and highlights the need to further address racial disparities in pediatric health care.

Blood Pressure Control and Risk Factors by Ethnicity
 African American
(N=41)
Non-African American
(N=85)
ρ-value
Controlled68%87%0.012
Overweight or obese62%60%0.877
CKD23%28%0.587
Family History of HTN82%76%0.472
>1 medication20%29%0.236

Pearson Chi-Square or Fisher's Exact Test as appropriate