042 - Relationship Between Anxiety and Hypertension Phenotypes among Adolescents

Publication Number: 42.6417

Nianzhou Xiao, Valley Children's Healthcare, Madera, CA, United States; Elizabeth A. Onugha, Baylor College of Medicine, Houston, TX, United States; Laide Jinadu, Valley Children's Healthcare, Fresno, CA, United States

Background: Elevated blood pressure (BP) readings in clinic are often attributed to White Coat Syndrome (WCS). Adult studies suggest that anxiety might be responsible for the presence of WCS. Ambulatory blood pressure monitoring (ABPM) is the gold standard to differentiate WCS from true hypertension (HTN). Recent studies suggest that WCS might be associated with increased risk of developing HTN and cardiovascular diseases. American Academy of Pediatrics Bright Futures recommend screening for anxiety starting at age 13 using the Generalized Anxiety Disorder 7-item (GAD-7) at regular checkups. It remains unclear whether anxiety severity based on GAD-7 screening is associated with HTN phenotypes (WCS vs HTN) among pediatric patients.

Objective: This study evaluates the relationship between anxiety and HTN phenotype among adolescents.

Design/Methods: This is a retrospective multicenter study. Inclusion criteria: Subjects aged 13 to 17 years old who had successful ABPM and completed GAD-7 questionnaires independently. Fisher-Freeman-Halton and Mann-Whitney U tests were performed to exam the association between GAD and ABMP interpretation. P- value < 0.05 is considered statistically significant.

Results: All participating sites obtained IRB approval. 24 subjects (16 males, 66.7%) were enrolled for data analysis. Gender was not associated with anxiety severity and ABPM result (p > 0.05). 14.3% of the adolescents in the WCS group were found to have moderate to severe anxiety. Prevalence of anxiety doubled (30%) among those with ABPM diagnosed HTN. There is no statistically significant association between anxiety severity and HTN phenotypes (WCS vs HTN) among pediatric patients (see Table 1).

Conclusion(s): Severity of anxiety was not associated with hypertension phenotypes: WCS vs HTN. Anxiety should not be assumed to be the cause of elevated BP readings among adolescents. We are actively enrolling more subjects because a larger study is warranted to validate the findings.

This is no association between anxiety severity and ABPM interpretation.
PAS table 1.pdfFisher-Freeman-Halton test was performed.