Kidney Week

Abstract: FR-PO387

Racial and Ethnic Disparities in Hypertension Severity and Target Organ Injury at Baseline in Youth Referred for Hypertension Disorders

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

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

Elizabeth Anyaegbu Onugha, MD

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

Ashna Pudupakkam, MD

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

Sahar Siddiqui, MD, MPH

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

Andrew M. South, MD, MS

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

Fallon Campbell, NP

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

Carol Vincent, MD

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

Giya Harry, MD, MSc, MPH

Background

Hypertension (HTN) in youth tracks into adulthood and is associated with subclinical cardiovascular disease. Target organ injury (TOI) is identified in up to 30% of children at HTN diagnosis and is associated with HTN severity. Although racial and ethnic disparities in HTN risk are well established, there is limited data on disparities in the association of HTN severity with TOI in children. We set out to describe racial/ethnic differences in the association between HTN severity and TOI at baseline in youth referred for HTN disorders.

Methods

Retrospective cross-sectional analysis of baseline data from the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO), a multisite Registry of youth referred to subspecialty care for HTN disorders using EHR 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 data. The exposure was stage 1 vs. stage 2HTN based on age, sex, and height-based U.S. guidelines. The outcome was TOI by ICD-10 codes. We conceptualized race/ethnicity as a social construct and defined it as an effect modifier; in this analysis. We estimated the associations with unadjusted generalized linear models with an interaction term and stratified models.

Results

Of the 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 5% had evidence of TOI. The overall TOI risk was 1.3 (95% CL 1.0–1.6). Stratification showed this risk was significant in Black/African American (RR 1.7, 95% CL 1.0–2.7) and Hispanic/Latino participants (RR 1.9, 95% CL 1.1–3.2), but there was no evidence of effect modification by race or ethnicity.

Conclusion

We did not find racial disparities in TOI risk based on HTN severity in our large and diverse multisite cohort of youth referred for hypertension disorders. Future studies will evaluate the impact of BP control on racial disparities in TOI risk.