Cardiometabolic Health in Children with Congenital Heart Disease
Variable Name
Study Dates
Last Modified
Tags
Publisher
Abstract
Study to address the implementation gap between guidelines and practice to improve cardiovascular health in children with congenital heart disease. The objective of this study is to determine the impact of hypertension on children with CHD over time.
Affiliation(s)
Funder(s)
Provenance
Description
The purpose of this study is to more clearly determine the burden of hypertension in children with CHD and the long-term impact of hypertension on cardiovascular outcomes in children with CHD towards the goal of improving their cardiovascular health. Our primary hypothesis is that hypertension will be under-diagnosed and under-treated and that there will be an exposure-response relationship between duration of hypertension (i.e., poor BP control) and MACE in children with CHD.
Study Aims
- Determine the frequency of undiagnosed hypertension in children with CHD.
- Determine the time within target BP range for children with CHD and HTN after diagnosis of HTN.
- Determine the long-term risk for major adverse cardiovascular events (MACE) in children with CHD and hypertension.
Study Design
The study design will consist of two parts with the first being a cross-sectional study and the second being a retrospective cohort study of children with CHD. Electronic health record (EHR) data between January 1, 2009 to December 31, 2024 will be analyzed to determine the frequency of hypertension in children with CHD through the cross-sectional study design. EHR data will also be used to determine the incidence of hypertension, the time within target BP range for those with hypertension, and the incidence of MACE by group using the retrospective cohort study design.
Cohort Description
Individuals aged ≤ 21 years with at least 1 ambulatory clinical encounter in the PEDSnet database between January 1, 2009 and December 31, 2024 will be identified. Laboratory only visits and imaging only visits will be excluded. Individuals will be required to have date of birth and sex recorded to be included. Patients with CHD will be identified using SNOMED CHD diagnosis codes (See Appendix). Severity of CHD will be classified according to the 2018 American Heart Association/American College of Cardiology adult congenital heart disease (ACHD) classification system of simple, moderate, and great complexity. For individuals with multiple CHD diagnosis codes, the primary CHD diagnosis listed in the PEDSnet database will serve to categorize the patient CHD status. If a primary CHD diagnosis is not listed, the diagnosis code with the greatest complexity will serve as the primary CHD diagnosis.
The index date will be the first entry of a CHD diagnosis code into the electronic health record system. This approach will include both the prevalent and incident cases of CHD at the index date.
Children with a diagnosis of hypertension or chronic kidney disease or need for kidney replacement therapy prior to CHD index date will be excluded (see Appendix).
Inclusion Criteria:
Patients aged 0-21 years with a diagnosis of congenital heart disease will be included in the study.
Exclusion Criteria:
Patients with a diagnosis of hypertension, chronic kidney disease, or kidney replacement therapy prior to index date (date of CHD diagnosis entry into electronic health record) will be excluded from the study.
Development Code
Vocabulary
Clinical Subjects Headings
Creative Commons license
