Kidney Week

Abstract: PUB429

Racial and Ethnic Disparities in the Association of Sleep-Disordered Breathing Diagnosis with Hypertension Severity at Baseline in Youth Referred for Hypertension Disorders

Session Information

• Publication Only

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Onugha, Elizabeth Anyaegbu, Texas Children's Hospital, Houston, Texas, United States

Elizabeth Anyaegbu Onugha, MD

• South, Andrew M., Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Andrew M. South, MD, MS

• Siddiqui, Sahar, Baylor College of Medicine, Houston, Texas, United States

Sahar Siddiqui, MD, MPH

• Pudupakkam, Ashna, Baylor College of Medicine, Houston, Texas, United States

Ashna Pudupakkam, MD

• Vincent, Carol, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Carol Vincent, MD

• Campbell, Fallon, Texas Children's Hospital, Houston, Texas, United States

Fallon Campbell, NP

• Harry, Giya, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Giya Harry, MD, MSc, MPH

Background

Sleep-disordered breathing (SDB) is associated with a higher risk of hypertension (HTN). Black/African Americans with SDB have more severe disease and are more susceptible to uncontrolled HTN compared with White adults. While Black/African American youth have a higher prevalence of SDB compared to White youth, racial and ethnic disparities in the association of SDB with HTN severity remain unknown. We set out to describe racial/ethnic differences in the association of SDB with baseline HTN severity in youth.

Methods

Retrospective cross-sectional analysis of baseline data from the Study of the Epidemiology of Pediatric HTN (SUPERHERO), a multisite Registry of youth referred to subspecialty care for HTN disorders using electronic health record data. Inclusion criteria were an initial subspecialty clinic visit for HTN disorders identified by ICD-10 codes from 1/1/2016–12/31/2023 and age <19 years. Exclusion criteria were youth on dialysis, kidney transplantation, or pregnancy by ICD-10 codes, as well as missing race or ethnicity data and blood pressure not in the HTN range. The exposure was SDB identified by ICD-10 codes. The outcome was stage 2 vs. stage 1 HTN based on age, sex, and height-based U.S. guidelines. We conceptualized race/ethnicity as a social construct and defined it as an effect modifier. We estimated the associations with unadjusted generalized linear models with an interaction term and stratified models.

Results

Of our cohort of 5,562 participants, mean age was 13.3 years (SD 4.1), 38% were male, 58% were White, 22% were African Americans and 19% were Hispanic/Latino. 39% had stage 2 HTN and 6% (n=549) had a diagnosis of SDB. Overall stage 2 HTN risk by SDB was 0.9 (95% CL 0.9–1.0). There was no significant effect modification, and stratified analyses showed no significant association in any group.

Conclusion

In our large cohort of youth referred for hypertension disorders, we did not observe racial or ethnic differences in the association of SDB with HTN severity at baseline. Equitable screening for and management of SDB in all populations is imperative.