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Teen having blood pressure checked

Study: Children in disadvantaged neighborhoods more likely to be diagnosed with hypertension

March 15, 2023

A new study found children’s odds of being diagnosed with hypertension were 60% higher when they lived in a disadvantaged neighborhood.

“Knowledge of risk factors for hypertension in youth is essential to improve cardiovascular outcomes later in life,” Carissa Baker-Smith, M.D., M.P.H., FACC, FAHA, FAAP, director of Pediatric Preventive Cardiology at Nemours Children’s Health, said in a press release. “Our study highlights the importance of considering neighborhood-related factors when diagnosing hypertension.”

Researchers set out to look at the relationship between children’s neighborhood and blood pressure using 2014-’19 data on more than 65,000 Delaware youths ages 8-18 years covered by Medicaid.

They gauged neighborhood socioeconomic status using the area deprivation index (ADI), which takes into account 17 factors such as home values, income, education and homeownership. Areas are rated on a scale of one to 100 with 100 being the most disadvantaged.

Children from disadvantaged neighborhoods (ADI scores of 50 and above) had 60% higher odds of being diagnosed with primary hypertension, according to “Association of Areas of Deprivation With Primary Hypertension Diagnosis Among Youth Medicaid Recipients in Delaware,” (Baker-Smith CM, et al. JAMA Netw Open, March 15, 2023).

Looking at individual characteristics, children with obesity had five times higher odds of a hypertension diagnosis. Children also had higher odds of a diagnosis if they were older, male and had spent a longer time covered by Medicaid. This study did not find a link between race/ethnicity and hypertension.

“Early life exposures to components of the built environment, including access to natural spaces, traffic, air pollution, noise, and meteorology, may be associated with hypertension prevalence at a young age,” authors wrote, citing other studies with similar findings.

About 4% of youths have primary hypertension, but the condition often goes undiagnosed. Authors encouraged clinicians to look beyond individual risk factors and consider neighborhood-level characteristics.




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