0832 Hypertension in Pediatric Patients Without Obstructive Sleep Apnea (OSA)

Abstract Introduction Studies show that sleep disturbances are associated with adult hypertension. The relationship between OSA and hypertension has been extensively studied, however, is understudied in pediatric patients without OSA. The aim of this study was to identify socioeconomic factors, social determinants, and medical co-morbidities associated with hypertension in pediatric patients without OSA based on polysomnography (PSG). Methods IRB-approved retrospective chart review of patients who underwent PSG at Nemours Children's Hospital, DE between January 2020 and July 2023. Eligibility criteria included children 8-17 years, completed PSG, and office visit blood pressure (BP) recordings. Anthropometrics, demographics, and socioeconomic, social determinants, and medical history obtained from EMR. Those without OSA based on PSG were divided into hypertensive and non-hypertensive groups. Hypertension was defined as the average (5 BP measurements from clinic visits within a year from PSG) systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) that is ≥95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. Height percentiles were calculated using CDC guidelines. Descriptive and comparative statistics were performed to compare the two groups. Data is reported as mean ± SD, non-hypertensive vs. hypertensive. Frequency of categorical data is reported in parentheses for the hypertensive group. Results Of the 228 patients, 108 did not meet criteria for OSA based on AHI2 and were excluded from the analysis (47.3%). Of the 108 without OSA, 22 were hypertensive (20.3%). All 22 had SBP ≥95th percentile; two had both SBP and DBP ≥95th percentile. Significant differences between hypertensives and non-hypertensives were in race (p=0.037, higher frequency of blacks), parents in household (p=0.042, lower frequency in those with both parents in the household), diabetes (p= 0.047, higher frequency of type 2 diabetes), and mental illness (p=0.027, higher frequency of autism and mood disorders). Daytime HR (96.2 ±12.4 vs 87.1±12.2, p=0.003), and BMI (2.7± 2.0 vs 1.1±1.8, (p 0.001) were both significantly higher in the hypertensive group. Conclusion In pediatric patients without OSA, there are multiple factors and co-morbidities associated with hypertension. Future larger studies are necessary to establish these associations and relationships in non-OSA patients. Support (if any)