부산대학교 도서관

Introduction: Hypertension (HTN) begins in youth and accounts for ~80% of the cardiovascular disease burden in the US. Socio/environmental factors are critical, and greater knowledge of the relationship between neighborhood level deprivation and blood pressure (BP) in youth is needed.Hypothesis: We hypothesized that greater neighborhood deprivation is associated with intermediate/poor BP status in adolescents even after adjusting for other factors.Methods: Data from 2009 to 2019 were extracted from PEDSnet (a PCORI-funded aggregate of pediatric health data). We modeled the relationship between BP and neighborhood deprivation based on national Area Deprivation index (ADI; scaled 1-100) tertiles (ADI<25=best/low, 25-52, >52=worst/high). The BP status of each youth was coded as good (BP score: 80-100) or intermediate/poor (BP score: 0-80) where BP score=100 if median BP <120/80mmHg and score=75 if median BP 120-129/<80mmHg. Analyses were carried out using SAS 9.4 with p<0.05 considered significant. The outcome of interest was poor/intermediate BP score.Results: Data from 122,177 youth, 13-17 years of age were analyzed. 51% were female, 58% were non-Hispanic white, and 22% non-Hispanic Black. 24% lived in neighborhoods with ADI <25; 35% lived in neighborhoods with ADI >52. In a multivariate logistic model, ADI > 52 was associated with a 49% greater odds of intermediate/poor BP score. Due to significant interactions between ethnicity-race and ADI, compared to non-Hispanic Black youth, non-Hispanic White and Other youth had lower odds of intermediate/poor BP score by univariate analysis, but greater odds in the full model (Table). Female sex was associated with lower odds of HTN. The model’s goodness of fit was strong with a ROC, AUC of 0.73 (Figure).Conclusions: Higher neighborhood deprivation is associated with greater odds of hypertension in adolescents. Greater emphasis on measures to mitigate this risk are needed.