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Cited by 139Blood Pressure and Hypertension StudiesGenetic and Clinical Aspects of Sex Determination and Chromosomal AbnormalitiesSexual Differentiation and Disorders

Blood pressure and Turner syndrome

Nathwani, Unwin, Brook, Hindmarsh·2000·Clinical Endocrinology
DOI 10.1046/j.1365-2265.2000.00960.x
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Abstract

INTRODUCTION: Elevated blood pressure (BP) is an important predictor of morbidity and mortality from cardiovascular disease. Patients with Turner syndrome (TS) have a higher morbidity and mortality in middle age than the normal population. As BP in childhood or early adulthood is predictive of BP later in adult life, we assessed manual and 24 h ambulatory BP in patients with TS to determine whether the BP pattern is altered at an early stage in these patients who are known to be at risk of cardiovascular disease. PATIENTS AND METHODS: We studied manual and 24 h ambulatory BP profiles in 75 girls with Turner syndrome, age range 5.4-22.4 years. A monitor with an oscillometric device (SpaceLabs model 90207) and an appropriate sized cuff was used. BP was measured during the day-time (0800-2000 h) and the night-time periods (2200-0800 h). The BP measured were compared with population standards. The effect of different growth promoting agents on BP was also evaluated. RESULTS: Mean manual and 24 h ambulatory BP measurements were 118/77 mmHg (range 95/60-140/102) and 115/70 mmHg (range 93/57-154/99), respectively. There was minimal difference between the two methods with a positive bias of 2.4 mmHg for diastolic BP and a negative bias of 2.1 mmHg for systolic BP. The mean standard deviation scores (SDS) corresponding to the mean BP recordings were 24 h systolic + 0. 81 (range - 1.26 to + 4.45), 24 h diastolic + 0.43 (range - 0.85 to + 3.42), day-time systolic + 1.08 (range - 0.95 to + 4.72), day-time diastolic + 0.70 (range - 0.94 to + 3.71), night-time systolic + 0. 22 (range -2.2 to + 3.64) and night-time diastolic - 0.18 (range -2. 0 to + 2.43). The SDS for both the mean 24 h and day-time systolic and diastolic BP were shifted to the right of the normal distribution. 57% of the girls had less than the normal 10% reduction in nocturnal systolic blood pressure. 17% had diastolic and 21% had systolic blood pressure above the 95th percentile for age and sex. There was no significant difference in the BP SDS between girls on no treatment and those receiving treatment. CONCLUSION: Over 50% of girls with Turner syndrome have an abnormal BP circadian rhythm, which is similar to adult patients with secondary hypertension. Patients with Turner syndrome have higher blood pressure measurements compared to published population standards, as evidenced by the shift to the right of both the systolic and diastolic BP SDS. These findings suggest that girls with Turner syndrome should be carefully monitored in childhood and adulthood for blood pressure and other cardiovascular risk factors.

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Authors
Nathwani, Unwin, Brook, & Hindmarsh
Affiliations
University College London (GB)
Corresponding author
Nathwani
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2000-03
Volume
52
Issue
3
Pages
363-370
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1046/j.1365-2265.2000.00960.x
OpenAlex
W1546212635
Cited by
139
References
44
Citations by year
2026: 2 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 2 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 5 · 2013: 9 · 2012: 4
FWCI
2.71
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 663 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
Turner syndrome, blood pressure, ambulatory blood pressure monitoring, cardiovascular risk, hypertension, growth hormone therapy, growth promoters, blood pressure variability, children and adolescents, cardiovascular disease prevention, menopause, menarche, hormone replacement therapy, body mass index, physical activity
MeSH terms
Adolescent, Adult, Analysis of Variance, Child, Child, Preschool, Circadian Rhythm, Cross-Sectional Studies, Drug Therapy, Combination, Estrogens, Female, Humans, Hypertension, Oxandrolone, Progesterone, Growth Hormone, Turner Syndrome, Blood Pressure Monitoring, Ambulatory, Anabolic Agents

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