Kidney Week

Abstract: FR-PO1071

Family History as a Risk Factor for Blood Pressure Control in Pediatric Hypertension

Session Information

• Pediatric Hypertension, AKI, Urologic Disorders
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1700 Pediatric Nephrology

Authors

• Betcherman, Laura, The Hospital for Sick Children, Toronto, Ontario, Canada

Laura Betcherman,

• Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada

Jessica Fitzpatrick,

• Jawa, Natasha, The Hospital for Sick Children, Toronto, Ontario, Canada

Natasha Jawa,

• Matsuda-Abedini, Mina, The Hospital for Sick Children, Toronto, Ontario, Canada

Mina Matsuda-Abedini,

• Langlois, Valerie, The Hospital for Sick Children, Toronto, Ontario, Canada

Valerie Langlois,

• Parekh, Rulan S., The Hospital for Sick Children, Toronto, Ontario, Canada

Rulan S. Parekh,

Background

Hypertension (HTN) in adults is aa leading cause of death worldwide. Pediatirc HTN often persists into adulthood. We investigated whether a family history of HTN influences blood pressure (BP) control in hypertensive children.

Methods

A retrospective chart review was done on patients aged 0-18 at a HTN clinic between 2002-2014. HTN was defined as a systolic or diastolic BP greater than the 95^th % for age and gender. Patients with chronic kidney disease and those without HTN were excluded. We included children with both primary and secondary HTN. Linear mixed effects regression models were used to compare BP z scores over time. Cox proportional hazards regression was used to assess time to achieve BP control, defined as a systolic and diastolic BP less than the 90^th %. Models were adjusted for age, gender and presence of antihypertensive medications.

Results

410 patients were included in the analysis. Mean age at diagnosis was 9.17 years and 268 (65%) were male. 233 (57%) had a positive family history of HTN. There was no significant difference in systolic BP Z scores over time between the two groups (p>0.5). Diastolic Z scores were significantly lower in those with family history compared to those without (p<0.01) [Figure]. There was no significant difference in achieving BP control between both groups (p>0.5).

Conclusion

There was a known family history of HTN in over 50% of children with HTN. Family history did not significantly affect longitudinal BP control nor the time it took to achieve good BP control. Future research should be directed at evaluating short and long-term outcomes in these children.

Figure 1 SBP and DBP z-scores over time. Model 1 unadjusted; Model 2 adjusted for age and gender; Model 3 adjusted for age, gender, number of antihypertensives