Kidney Week

Abstract: FR-PO390

Exploring Social Determinants of Hypertension (HTN)

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Ernest, Deepali Karina, University of Houston, Houston, Texas, United States

Deepali Karina Ernest, MPH

• Dave, Jayna M., Baylor College of Medicine, Houston, Texas, United States

Jayna M. Dave, PhD

• Onugha, Elizabeth Anyaegbu, Baylor College of Medicine, Houston, Texas, United States

Elizabeth Anyaegbu Onugha, MD

Background

Many social determinants of health (SDoH) are associated with HTN in adults, but little is known about their contribution to adolescent HTN. We examined the independent and joint effect of common SDoH on HTN among adolescents.

Methods

National Health and Nutrition Examination Survey (2013-2020) data for adolescents 13-18 years were cross-sectionally analyzed. HTN was defined as systolic blood pressure ≥ 130 and/or diastolic blood pressure ≥80mmHg. SDoH included food security, healthcare access, and economic status. SDoH were scored (0=favorable condition, 1=unfavorable condition) and summed to create a joint-impact score (0-9) divided into tertiles. Weighted logistic regression models determined the independent and joint impact of SDoH on HTN risk. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported.

Results

Overall 2,623 adolescents were included (mean age=15.4 years, 50% female, and 58.2% White). 2.9% had HTN, 33% had obesity (BMI>95^th percentile), 21% were food insecure, 41% received SNAP benefits, 8% had no health insurance, 12% had no routine place for healthcare, and 47% had family poverty index (FPI) ≤1.85. Receiving SNAP benefits was significantly associated with higher odds of HTN (p<0.05). After adjustment for obesity and race/ethnicity, being non-Hispanic Black, receiving SNAP benefits, not having a routine healthcare site, no insurance, foreign-born, English speaking and FPI≤1.85 had increased odds of hypertension. Every 1 unit increase in SDoH score was associated with 11% higher odds of HTN [aOR=1.11; 95% CI: 0.94, 1.32]. Adolescents with SDoH scores in tertile 2 had significantly higher odds of HTN [aOR=2.53; 95% CI: 1.09,5.88; p=0.03] vs. those in tertile 1.

Conclusion

Our findings suggest that SDoH related to food security & assistance, and healthcare access are associated with higher odds of HTN among adolescents and SDoH can cumulatively contribute to the likelihood of HTN in this population.