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Abstract: TH-PO593

Social Determinants of Health and Blood Pressure in Children: Interim Analysis of the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) Registry

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Sethna, Christine B., Cohen Children's Medical Center, Queens, New York, United States
  • Biswas, Shupti, Cohen Children's Medical Center, Queens, New York, United States
  • Giammattei, Victoria, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Lucas, Caroline, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Vincent, Carol, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Viviano, Irina, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Weaver, Donald J., Levine Children's Hospital, Charlotte, North Carolina, United States
  • South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Background

Social determinants of health (SDoH) are known to impact chronic health conditions, however the relationship between SDoH and hypertension (HTN) in children has not been well-studied. The objective was to determine the association of unmet social needs (USN) with blood pressure (BP) classification and initial evaluation/management among youth referred for HTN.

Methods

Interim analysis of baseline data from the SUPERHERO Registry, a multicenter retrospective cohort of youth referred for HTN disorders, was conducted. Data were collected via standardized electronic health record queries. Inclusion criteria were initial visit to a subspecialty clinic for HTN disorders by ICD-10 codes from 1/1/2016–12/31/2021 and age <19 years. Exclusion criteria were dialysis, kidney transplantation, or pregnancy by ICD-10 codes. USN exposures included problems related to housing/economic circumstances, social environment, upbringing, and other psychosocial circumstances by ICD-10 codes. Unadjusted generalized linear models estimated the association of USN with outcomes of BP and orders for antihypertensive medication, echocardiogram, and urine protein.

Results

Of 3295 participants, median age was 14.2 years [10.5,16.4], 63% were male, 29% identified as Black, and 52% had obesity. There were 16 USN diagnosis codes identified among 10 participants: 13 housing/economic, 1 social environment, 1 upbringing, and 1 other psychosocial circumstance. BP classification included elevated BP 17%, stage 1 HTN 34%, and stage 2 HTN 26%. Participants with USN were more likely to have obesity and, among age ≥13 years, higher diastolic BP, p <0.05. Having USN was associated with HTN (RR 1.45, CL1.18-1.78), greater systolic BP (≥13 years only, β 13.0 mmHg, CL0.7-25.2), and greater diastolic BP (≥13 years only, β 12.4 mmHg, CL3.0-21.8). Those with USN were also more likely to have orders placed for anti-hypertensive medications (RR 1.93, CL1.03-3.59).

Conclusion

In a large multicenter cohort of youth referred for evaluation of HTN disorders, patients with USN were more likely to have HTN, greater BP and were more likely to be prescribed antihypertensive medications. Ongoing steps include multivariable analysis to further investigate SDoH in youth with HTN.

Funding

  • NIDDK Support