Abstract 15904: Hypertension Risk in Adolescent Females With Polycystic Ovary Syndrome

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Background: Polycystic ovary syndrome (PCOS) is associated with increased risk of hypertension (HTN) in adult women, but fewer studies have examined PCOS and HTN among adolescents. Characterizing blood pressure (BP) by PCOS status prior to adulthood may inform early cardiovascular risk surveillance efforts. Aim: To examine the prevalence of hypertension-range BP (HTN-BP) in adolescent females with and without PCOS and to characterize the association of PCOS and HTN-BP. Methods: We used data from an existing cohort of 171,855 females aged 13-17y in a US healthcare system with well-child visit (2012-2018) and measured systolic/diastolic BP. The 2017 American Academy of Pediatrics Practice Guideline was used to classify normal BP [<120/<80], elevated BP [120/<80-129/<80], stage 1 HTN [130/80-139/89] and stage 2 HTN [≥140/90 mmHg]. PCOS was based on clinical diagnosis (ICD-9 265.4, ICD-10 E28.2) within 1 year of the visit. Body mass index (BMI) was classified as healthy, overweight, moderate and severe obesity using BMI percentile data; 3062 underweight females were excluded from analyses. Differences by PCOS (N=1142) and no PCOS (N=167,651) status were compared. Multivariable logistic regression examined the association of PCOS and HTN-BP, with adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results: The cohort included 168,793 females (33.6% non-Hispanic White, 9.7% Black, 30.5% Hispanic, 19.9% Asian/Pacific Islander, and 6.3% other/unknown race ethnicity), of whom 65.9% had healthy weight, 18.7% overweight, and 15.4% obesity. Based on visit BP data, 75.6% were normotensive, 17.5% had elevated BP, and 7.0% had HTN-BP (6.1% Stage 1, 0.9% Stage 2). HTN-BP prevalence was much higher for PCOS vs no PCOS (18.6% vs 6.9%, p<0.001). After accounting for age, race/ethnicity, and BMI level, PCOS was associated with 1.3-fold greater odds of HTN-BP (aOR 1.3, CI 1.1-1.5). Similar findings were seen among females with obesity (aOR 1.3, CI 1.1-1.6). Conclusions: Prevalence of HTN-BP was 30% higher for those with PCOS after adjusting for BMI, race/ethnicity, and age. Similar findings were evident among those with obesity. Future studies should examine persistent HTN and the independent association of PCOS and HTN severity in this high-risk population.