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Abstract: TH-PO498

Sleep-Disordered Breathing, Risk of Target Organ Injury, and Role of Obesity in Youth Referred for Hypertension Disorders

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Weaver, Donald J., Levine Children's Hospital, Charlotte, North Carolina, United States
  • Chanchlani, Rahul, McMaster University, Hamilton, Ontario, Canada
  • Kiessling, Stefan, University of Kentucky, Lexington, Kentucky, United States
  • Murphy, Margaret, University of Kentucky, Lexington, Kentucky, United States
  • Riar, Sandeep K., Emory University School of Medicine, Atlanta, Georgia, United States
  • Sethna, Christine B., Cohen Children's Northwell Health Physician Partners Pediatric Nephrology and Kidney Transplant, Queens, New York, United States
  • Yamaguchi, Ikuyo, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
  • South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Background

Sleep-disordered breathing (SDB) has adverse consequences on blood pressure regulation in adults, but its relationship with target organ injury (TOI), especially in youth, is less clear. Our objective was to determine if SDB is associated with higher risk for TOI in youth referred for hypertension disorders and if obesity magnified this risk.

Methods

Interim cross-sectional analysis of baseline data from the multisite Study of the Epidemiology of Pediatric Hypertension Registry (SUPERHERO) which retrospectively collects electronic health records data using biomedical informatics scripts. Inclusion criteria were initial visit for hypertension disorder based on ICD-10 codes between 1/1/2015 and 12/31/2022 and age <19 years. Exclusion criteria were kidney transplant, dialysis, or pregnancy per ICD-10 codes at the index visit. Exposures were ICD-10 code-defined SDB, and obesity by body mass index percentile was our effect modifier. Outcomes were ICD-10 code-defined heart and kidney TOI at the index visit. We used unadjusted generalized linear models.

Results

In this analysis of 11,580 participants, mean age was 12.0 + 5 years, 52% had obesity, 4% has SDB, and 8 % had TOI (Table). Compared to participants without SDB, those with SDB had a 57% lower risk of TOI (RR 0.43, 95% CL 0.26 to 0.69). Obesity was associated with a lower magnitude of association, though not significantly (interaction p-value 0.08).

Conclusion

In a large multisite registry of youth referred for hypertension disorders, participants with an ICD-10 code for SDB at baseline had a lower risk of TOI by ICD-10 code. Next steps include better defining our exposure and outcome. Further studies are needed to determine if clinical interventions that impact sleep health can mitigate future cardiovascular risk in youth.

Funding

  • Other NIH Support