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Abstract: FR-PO1066

Persistence of Hypertension from 5-7 Years After Pediatric Cardiac Surgery

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Greenberg, Jason Henry, Yale University, Woodbridge, Connecticut, United States
  • Zappitelli, Michael, Toronto Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
  • Thiessen Philbrook, Heather, Johns Hopkins University, Newton, Massachusetts, United States
  • Jia, Yaqi, Johns Hopkins University, Newton, Massachusetts, United States
  • Devarajan, Prasad, Cincinnati Children's Hospital, Cincinnati, Ohio, United States
  • Parikh, Chirag R., Johns Hopkins University, Newton, Massachusetts, United States

Group or Team Name

  • TRIBE-AKI Consortium
Background

We have determined that children who require surgery for congenital heart disease (CHD) are at an increased risk for hypertension 5 years after cardiac surgery. The goal of this study is to assess the long-term risk of hypertension after cardiac surgery and if hypertension improves or is sustained.

Methods

We prospectively enrolled children from 1 month to 18 years old, undergoing cardiopulmonary bypass. Children who survived their surgical hospitalization had blood pressure measured at two in-person follow-up visits (median 5.4 years and 7.4 years after surgery). Elevated blood pressure and hypertension was defined using the American Academy of Pediatrics 2017 Hypertension guidelines. We compared the risk of hypertension status at the 5 and 7-year visits using the McNemar test.

Results

Of the 131 children with a follow-up visit 5 years after cardiac surgery, 88 (67%) children participated in the 7-year follow-up visit. Baseline characteristics were not significantly different between children that participated in both the 5 and 7-year visit vs those who only participated in the 5-year visit. The median age of the cohort at the 7-year follow-up was 10.6 [IQR: 7.6 – 15.2] years and 47% were female. 32 children had previously had a septal defect repair, 15 an inflow/outflow tract or valve procedure, 34 had a combined procedure, and 7 were not defined. Elevated BP was present in 16 (18%) and 13 (15%) children at the 5-year and 7-year visit, respectively. Hypertension was present in 13 (15%) and 15 (17%) children at the 5-year and 7-year visit, respectively, with no statistically significant change in risk at the two visits (p=0.56). Between the 5-year and 7-year visits, hypertension was sustained in 8 (62%) patients.

Conclusion

The long-term risk of elevated blood pressure and hypertension was common at both the 5 and 7-year visits and hypertension was sustained in the majority of children after cardiac surgery. The risk factors for sustained hypertension should be studied in children with congenital heart disease.

Funding

  • NIDDK Support