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Abstract: TH-PO592

Anxiety Disorders and Hypertension 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

Studies in adults have linked anxiety disorders with hypertension, however not much is known about this relationship in children. The study aimed to assess the association of anxiety disorders with blood pressure classification and initial evaluation/management among youth referred for subspecialty evaluation of hypertension.

Methods

Interim analysis of baseline data from the SUPERHERO Registry, a multicenter retrospective cohort of youth referred for hypertension disorders, was conducted. Data were collected via standardized electronic health record queries. Inclusion criteria were initial visit to a subspecialty clinic for hypertension disorders identified by ICD-10 codes from 1/1/2016–12/31/2021 and age <19 years. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. The primary exposure was anxiety disorders identified by ICD-10 codes “other anxiety disorder”, “reaction to severe stress, and adjustment disorders”, and “emotional disorders with onset specific to childhood”. Outcomes were blood pressure classification and orders for antihypertensive medication, echocardiogram, and urine protein/albumin. Associations were estimated using unadjusted generalized linear models.

Results

Of 3295 participants, median age was 14.2 years [10.5, 16.4], 63% were male, 29% identified as Black or African American, and 52% had obesity. There were 36 anxiety disorder diagnosis codes identified among 26 participants. Blood pressure classification included elevated blood pressure 17%, stage 1 hypertension 34%, and stage 2 hypertension 26%. Participants with anxiety disorders were more likely to identify as White and less likely to be prescribed anti-hypertensive medication (p <0.05). In regression analysis, participants with anxiety disorders were more likely to have orders placed for urine albumin (RR 1.26, CL 1.02 to 1.55).

Conclusion

In a large multicenter cohort of youth referred for subspecialty evaluation of hypertension disorders, patients with anxiety diagnoses were more likely to have urine tests ordered. It is very probable that anxiety disorders are underreported by ICD-10 codes in the electronic health record in this population.

Funding

  • NIDDK Support