Abstract 11678: Prevalence of Elevated Blood Pressure and Left Ventricular Hypertrophy in Adolescents With Congenital Heart Disease

Abstract

Introduction: Left ventricular hypertrophy (LVH) is defined as LVM indexed to height 2.7 (LVMi-HT 2.7 ≥ 51 g/ht 2.7 in men, ≥ 47 g/ht 2.7 in women), and ≥ 38.6 g/ht 2.7 in the pediatric population. LVH associated with hypertension (HTN) is a predictor of adverse cardiovascular (CV) events in adulthood. Adults with congenital heart disease (CHD) have higher rates of HTN compared to the general adult population. Data on the prevalence of elevated systolic blood pressure (SBP) in youths with CHD is limited. The aim of our study was to determine the prevalence of elevated SBP and LVH in adolescents with CHD. Hypothesis: We hypothesized that youths with elevated SBP will have increased LVMi-HT 2.7 by echocardiography. Methods: We retrospectively analyzed echocardiograms with a diagnosis code of CHD from 2012 to 2019. We included patients aged 13-17 years with documented BP, height, weight, and echocardiography measurement for LVMi-HT 2.7 . Patients were grouped by BP category into normotensive (NT, SBP < 120 mm Hg), elevated BP (E-BP, 120 ≤ SBP < 130 mm Hg), Stage 1 HTN (HTN-1, 130 ≤ SBP < 140 mm Hg), and Stage 2 HTN (HTN-2, SBP ≥ 140 mm Hg). The prevalence of LVH was reported in each group defined as LVMi-HT 2.7 ≥ 38.6 g/ht 2.7 . Results: 855 patients were included with a mean age of 15.5±1.5 years with 485/855 (56.7%) male, SBP 117±13.5 mm Hg, and LVMi-HT 2.7 34.2±10.5 g/ht 2.7 . 493/855 (57.7%) were in the NT group, 214/855 (25%) in E-BP, 99/855 (11.6%) in HTN-1, and 49/855 (5.7%) in HTN-2. The prevalence of LVH increased with higher SBP with 96/493 (19.5%) in NT, 80/214 (37.4%) in E-BP, 32/99 (32.3%) in HTN-1, and 20/49 (40.8%) in HTN-2. Of the youths with LVH, 49/228 (21.5%) met adult criteria of ≥ 51 g/ht 2.7 . Conclusions: Youths with CHD have a high prevalence of elevated BP, HTN, and LVH. These findings support the importance of early detection and screening for high BP in this group because youths with CHD have baseline increased CV risk that may be compounded by HTN. Future studies will be needed to determine longitudinal changes and the influence of body mass index and sex on BP in this group.