{
  "abstract": "Background The role of social determinants of health (SDoH) in hypertension-related outcomes remains underexplored yet it remains a major risk factor for heart failure.This study examined the association between SDoH and adverse cardiovascular events in a multinational cohort of hypertensive patients when HF has been excluded.Methods A retrospective cohort study was conducted using a global federated health research network. Patients were classified as socially deprived based on ICD-coded indicators of four SDoH factors: extreme poverty, unemployment, living alone, and low income.The primary outcome was the 5-year risk of a composite measure including all-cause mortality, ischemic heart disease (IHD), cerebrovascular accident (CVA), heart failure (HF), angina pectoris, acute myocardial infarction (AMI), atrial fibrillation/flutter, and cerebral infarction. Secondary outcomes assessed individual components of the composite outcome. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after 1:1 propensity score matching (PSM).Results Initial cohorts consisted of 39,577 socially deprived hypertension patients and 10,717,206 non-deprived patients with hypertension without heart failure. After propensity score matching, the study included 39,307 socially deprived (68.6 +/- 13.5 years; 55.3% female) and 39,307 non-deprived (68.6 +/- 13.5 years; 55.3% female) hypertensive patients. (Results in table 1) Socially deprived individuals had a significantly higher risk of the primary composite outcome MACE (HR 1.58, 95% CI 1.53–1.63) and HF (HR 2.92 95% CI 2.11, 2.51 p <0.005). Similarly, there was an increased risk for secondary individual components of the composite outcome (Results in Table: table 2).Conclusion Social deprivation is strongly associated with increased risk of adverse major cardiovascular events among hypertensive patients. Future prospective studies are needed to address potential unmeasured confounders with the retrospective design and validate these findings.Abstract 5-020 Table 1Baseline characteristics before and after propensity score matching in socially deprived and non-deproved patient with hypertensionAbstract 5-020 Table 2Number and risk of adverse event after propensity score matching in socially deprived and non-deprived patients with hypertension",
  "authors": [
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Elliot Mbeta"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "Department of Cardiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Rajiv Sankaranarayanan"
    },
    {
      "affiliations": [
        "TriNetX inc",
        "London, UK"
      ],
      "name": "Philip Austin"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Peter Penson"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK",
        "Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"
      ],
      "name": "Gregory YH Lip"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK",
        "Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK",
        "Research Laboratory, Liverpool Heart and Chest Hospital Liverpool, England, UK"
      ],
      "name": "Garry McDowell"
    }
  ],
  "title": "5-020 Social determinants of health and adverse clinical outcomes among patients with hypertension a real-world analysis using a global federated database",
  "uid": "a033d191-5e12-5dfa-99bc-04616085eaf1"
}