412 - Influence of Neighborhood Disadvantage and Sleep Duration on Pediatric Hypertension

Publication Number: 1395.412

Armando S. Amador, Baylor College of Medicine, Pasadena, TX, United States; Deba Elaiho, Baylor College of Medicine, Houston, TX, United States; Madhumithaa Venkatesalu, Baylor College of Medicine, Houston, TX, United States; Kenneth Nobleza, Baylor College of Medicine, Houston, TX, United States; Duc T. Nguyen, Baylor College of Medicine, Houston, TX, United States; Elizabeth A. Onugha, Baylor College of Medicine, Houston, TX, United States

Background: Hypertension (HTN) is a leading modifiable risk factor for cardiovascular (CV) disease. Disparities in the prevalence of pediatric HTN highlight the role of social determinants of health in shaping health outcomes. Sleep is gaining attention for its influence on HTN. A recent study found that longer sleep duration and earlier sleep onset were associated with lower daytime BP. Neighborhood quality may further shape both sleep and CV health. Sleep disparities reflect broader health disparities, with minority children experiencing shorter sleep durations. Although adults living in areas of higher deprivation have been shown to have higher rates of HTN, few studies have examined how these social and environmental factors affect sleep and pediatric BP.

Objective: To evaluate the association between sleep duration and HTN, mediated by neighborhood socioeconomic status (SES). We hypothesized that shorter sleep duration, mediated by neighborhood social disadvantage, would be associated with a higher prevalence and greater severity of HTN.

Design/Methods: We retrospectively analyzed data of 136 pediatric patients seen at the Texas Children’s Hospital HTN clinic in 2024. HTN was confirmed via ambulatory BP monitoring. Sleep duration was derived from patient reported sleep and wake times. Neighborhood SES was assessed using the Area Deprivation Index, a composite measure of area-level deprivation categorized into quartiles, with Q1 indicating least and Q4 most deprivation.
Patient characteristics were reported as frequencies and proportions for categorical variables as median and interquartile range (IQR) for continuous variables. Group differences were determined using chi-square or Fisher’s exact tests for categorical variables, and Kruskal Wallis test for continuous variables. HTN and sleep duration distributions were depicted by bar charts

Results: Of 69% (94/136) patients diagnosed with HTN, 28 had a short sleep duration and 66 had adequate sleep. There was no significant association between sleep duration and HTN prevalence (p = 0.87) nor HTN severity (p=0.56). Neighborhood disadvantage did not mediate HTN severity at diagnosis (p = 0.36).

Conclusion(s): We found that sleep duration was not associated with the prevalence or severity of HTN in pediatric patients referred for HTN, nor was it mediated by neighborhood ADI. Future work will include more objective measures of sleep duration and quality rather than patient-reported metrics.

Patient Characteristics
Table 1 for abstract.pdf

Association between Short Sleep Duration and Adequate Sleep with HTN Risk
Figure 1_for_abstract_short_vs_adequate.pdf