Endocrine Abstracts (2016) 45 P46 | DOI: 10.1530/endoabs.45.P46

Blood pressure monitoring and management in young girls with turner syndrome

Mohammed Ibrar Murtaza1,2, Ellen Anderson1,2, Emma Leighton2, Sze Choong Wong2 & Avril Mason2

1School of Medicine, University of Glasgow, Glasgow, UK; 2Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK.

Background: Hypertension is common in adults with Turner Syndrome (TS) but less is known about hypertension in children with TS.

Aim: To determine the frequency of hypertension in a contemporary paediatric TS cohort and to assess its association with clinical characteristics.

Patients and methods: Preliminary analysis of 22 girls with TS attending a designated TS clinic at RHC, Glasgow, with at least 2 blood pressure measurements in the preceeding 12 months. Hypertension was defined by systolic or diastolic BP measurement ≥95th percentile for gender and height on 2 consecutive visits in one year. Stage 1 hypertension (95th–99th centile) and stage 2 hypertension (>99th centile).

Results: Median age at last clinic visit was 13 years (4,19), HtSDS −2.0 (−3.3, −0.8), BMISDS 0.3 (−3.2, 3.2). 10/22 had karyotype of 45X,0. None has a history of coarctation of aorta. 8/22(36%) were hypertensive: 4/8 were defined as stage I hypertension and 4/8 as stage II hypertension. 4/22(18%) were on anti-hypertensive therapy, however 2/4(50%) remained hypertensive. Of the other six who were hypertensive but not on treatment, 3/6 have been referred for 24 hour ambulatory blood pressure monitoring.

Multivariate logistic regression analysis for factors associated with hypertension using age (95% CI 0.59 to 1.93), BMISDS (0.96 to 6.47), tanner stage (95% CI 0.25 to 9.01) and karyotype (95% CI 0.09 to 8.15)as independent factors showed that there were no single independent factor associated with hypertension in girls with TS.

Hypertensive (n, 8)Not hypertensive (n, 14)P value
Age (years)14.9 (11.0, 19.6)12.3 (4.0, 17.6)0.15
Ht SDS−1.8 (−3.1, −0.8)−2.1 (−3.3, −1.0)0.27
BMI SDS1.8 (−1.1, 3.2)0.1 (−3.2, 2.4)0.02
Bicuspid aortic valves1/8 (13%)2/14 (14%)
Growth hormone 4/8 (50%) 9/14 (64%)0.51
Oestrogen4/8 (50%)6/14 (43%)0.75
45X3/8 (38%)7/14 (50%)0.57

Conclusion: Our current study demonstrated that 36% of young TS girls were hypertensive based on clinic measurements. No single factor was predictive of hypertension in our study. Optimal monitoring and management of blood pressure in paediatric TS is unclear and deserves future study.

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