543 - Mood Disorders and Cardiovascular Disease Risk: Impact of Treatment and Biological Sex

Poster Number: 543
Publication Number: 543.423

Pranjal Agrawal, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Jeffrey Garofano, Johns Hopkins University School of Medicine, BALTIMORE, MD, United States; Carisa Parrish, Johns Hopkins Children's Center, Baltimore, MD, United States; Jason Ong, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Kevin Psoter, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Tammy M. Brady, Johns Hopkins University, Baltimore, MD, United States

Background: Youth with obesity have a 2.5-fold higher prevalence of mood disorders (MDO) than the general pediatric population and MDO in this high-risk population is associated with significantly higher blood pressure (BP), central adiposity, and hypertension. Further female adolescents are 2x more likely to have depression/dysthymia.

Objective: We sought to determine the association between treated and untreated MDO with CVD risk factors (RF) among children with overweight/obesity and a history of elevated BP and to explore if sex modifies this association.

Design/Methods: A retrospective cohort study of youth was evaluated and followed in a multidisciplinary obesity hypertension clinic from 2015-2021. All patients underwent standardized CV assessment and MDO screening via validated tools and psychologist assessment. Individuals were classified into three groups: those with no MDO, treated MDO (on medication and/or receiving therapy), and untreated MDO, and baseline characteristics were compared. Multivariable linear and relative risk regression based on generalized estimating equations to account for repeated measurements of individuals during follow-up were used to evaluate the association of MDO status with CVDRFs. Effect modification by sex was explored.

Results: 106 youth were included in this analysis; at baseline, 29% had MDO, and 61% of those were treated. The mean age was 13.7 years with 59% male and 75% Black race. Children with MDO tended to be older with greater weight, OSA prevalence, and aspartate aminotransferase levels than those without MDO (Table 1). In general, more favorable CVDRF outcomes were present in individuals with no MDO, followed by those with a treated MDO and least favorable in those with untreated MDO. (Table 2) Compared to no MDO, untreated MDO was independently associated with higher systolic BP, diastolic BP (DBP), and DBP index whereas there were no significant differences in CVD outcomes between treated MDO and no MDO (Table 3). There were no statistically significant interactions between sex and MDO status.Conclusion(s): We found untreated MDO among children with overweight/obesity and a history of elevated BP to be independently associated with greater BP when compared to those without MDO. Importantly, treated MDO was not associated with a greater risk of any CVDRF compared to those without MDO. These data support the need for greater mental health support and services in this high-risk population.
APA AWARD CV_Pranjal AgrawalResume.pdf

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