Abstract 18937: High Prevalence of Pediatric Hypertension is Associated With Social Determinants of Health Including Childhood Opportunity Index

Abstract

Background: Pediatric Hypertension(HTN) is a significant public health concern. The risk for adult HTN and end-organ damage begins in childhood. Patient factors such as social determinants of health (SDOH), including the Childhood Opportunity Index (COI) and how they impact the prevalence of pediatric HTN are poorly understood. Hypothesis: Elevated blood pressure (BP) and BP in the hypertensive range are prevalent in pediatric patients. SDOH factors are associated with high BP(elevated BP or BP in the hypertensive range). Methods: Patients seen in primary care at Nemours Children’s Health (NCH) between 6-17 years formed the cohort and various SDOH factors including COI were analyzed. Results: 95,627 patients aged 6-17 years seen at NCH from DE and PA formed the cohort between August 2017 and September 2022. Children with developmental delay, anxiety, ADHD were excluded. The overall prevalence of elevated BP was 9.5% and BP in hypertensive range was 2.8% based on the definition from the American Academy of Pediatrics 2017 HTN guidelines. A multivariable analysis showed factors associated with having a high BP were living in DE(P<0.001), non-English speaking(P<0.001), non-white race(P=0.03), being on public insurance(P<0.001), Male gender(P<0.001), older age(P<0.001), and low COI(P<0.001) with a C statistic of 0.77. Conclusions: Elevated BP and BP in the hypertensive range are prevalent across pediatric patients. Various SDOH factors are associated with having a high BP including COI, which indicates the vulnerability of certain populations to having high BP and development of adult HTN and future cardiovascular risk. Understanding these SDOH factors could help recognize and treat pediatric patients with HTN.