716 - Race and Ethnicity Differences in Baseline Prevalence of Cardiovascular-Kidney-Metabolic Syndrome and AHA Pediatric Cardiovascular Risk in Youth with Hypertension Disorders: A SUPERHERO Analysis

Publication Number: 716.6427

Andrew M. South, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Rushelle Byfield, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Jessica Fallon. Campbell, Baylor College of Medicine, Houston, TX, United States; Giya Harry, Wake Forest School of Medicine, Winston salem, NC, United States; Margaret Murphy, University of Kentucky College of Medicine, Lexington, KY, United States; Elizabeth A. Onugha, Baylor College of Medicine, Houston, TX, United States; Ashna Pudupakkam, Baylor College of Medicine, Houston, TX, United States; Sandeep Riar, Children's Healthcare of Atlanta, Atlanta, GA, United States; Sahar Siddiqui, Texas Children's Hospital, Houston, TX, United States; Michael J. Walsh, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Carol Vincent, Wake Forest Baptist Health - Brenner Children's Hospital, Winston Salem, NC, United States

Background: Both the recent AHA Presidential Advisory on cardiovascular (CV)-kidney-metabolic (CKM) syndrome and Scientific Statement on CV Risk Reduction in High-Risk Pediatric Patients were published to better assess CV risk and reflect the complexity and multiorgan involvement of CV disease pathophysiology.

Objective: Estimate race and ethnicity differences in prevalence of CKM syndrome and AHA CV risk in youth with hypertension (HTN) disorders.

Design/Methods: Descriptive cross-sectional analysis of baseline data from 7 sites in the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO), a retrospective Registry of EHR data using biomedical informatics scripts validated by manual record review. Inclusion criteria were youth < 19 years old with HTN disorders from 1/1/16–12/31/23 per ICD-10 codes. Exclusion criteria were dialysis, kidney transplantation, or pregnancy by ICD-10 codes. Race and ethnicity were reported per the EHR and as defined by the US Census. Using ICD-10 codes, BP, and BMI, we defined CKM syndrome as Stage 0–2 or Unclassified and AHA risk as At Risk, Moderate, High, or Unclassified; for both groups, “Unclassified” included participants who lacked data or who did not meet criteria for any classification. We reported n (%) and estimated differences among groups using chi-square test.

Results: Of 9,355 participants, 20% had CKM syndrome Stage 1 and 65% Stage 2, while for AHA risk, 7% had At Risk, 65% Moderate Risk, and 11% High Risk. CKM syndrome and AHA risk differed by race and ethnicity (p < 0.001). Native Hawaiian or Other Pacific Islander had the lowest prevalence of Stage 1 or Stage 2 CKM syndrome (67%), while American Indian or Alaska Native had the highest Stage 1 or Stage 2 prevalence (90%). Native Hawaiian or Other Pacific Islander had the lowest prevalence of AHA Moderate Risk (33%) but highest prevalence of High Risk (22%). American Indian or Alaska Native had the highest AHA Moderate Risk (77%) but lowest High Risk (3%).

Conclusion(s): We observed moderate race and ethnicity differences in baseline CKM syndrome stage and AHA risk categorization in youth with HTN disorders. Ongoing SUPERHERO efforts include improving CKM syndrome and AHA risk case definitions and estimating if race or ethnicity healthcare disparities exist in HTN management.