Abstract Body: Background: Asthma is one of the most common lung disorders and is a risk factor for cardiovascular disease. In adults, asthma and hypertension (HTN) are frequent comorbidities with cardiovascular disease; however, less is known in youth.

Objective: Determine if asthma is associated with blood pressure (BP) severity, target organ injury (TOI), and cardiovascular health at baseline in youth with HTN disorders.

Design/Methods: Cross sectional analysis of baseline data from the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) Registry, a multisite retrospective cohort of youth referred to subspecialty care for HTN disorders using electronic health record data. Inclusion criteria were an initial subspecialty clinic visit for HTN disorders identified by ICD-10 codes from 1/1/2016–12/31/2023 and age <19 years. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. Exposure included asthma identified by ICD-10 codes. Unadjusted generalized linear models estimated the association of asthma with the outcomes of BP severity with z-scores and classification per US guidelines, obesity by BMI or weight-for-length percentiles, TOI, dyslipidemia, and hyperglycemia by ICD-10 codes.

Results: Of the 9,356 participants, mean age was 12.8 ± SD 4.5 years, 62% were male, and 3% (n=250) had asthma. Participants with asthma were more likely to be male and had higher risk of obesity (RR 1.28, 95% CL 1.11–1.48), dyslipidemia (RR 2.52, 95% CL 1.91–3.32), hyperglycemia (RR 1.95, 95% CL 1.46–2.61), and number of cardiovascular health risk factors (OR 2.53, 95% CL 1.99–3.21).

Conclusions: In a large multisite cohort of youth referred for HTN disorders, prevalence of asthma was associated with heightened risk for obesity and several cardiovascular health risk factors but not BP severity or TOI. This work suggests that asthma contributes to early cardiovascular disease risk in youth and should be a focus of targeted interventions. Ongoing work will investigate pharmacological and nutritional management to better inform targeted interventions and therapeutic treatment strategies for youth with asthma and HTN disorders.