Natural history of hypertension in Turner syndrome during a 12-year pragmatic interventional study
Abstract
Turner syndrome is caused by complete or partial X monosomy in some or all cells. Cardiovascular complications are dominant, including increased blood pressure (BP), leading to early-onset hypertension. The aim is to describe the debut, development, and treatment of hypertension in Turner syndrome during a 12-year pragmatic interventional study to help identify risk factors associated with hypertension. One hundred and two women (aged 38±11 years, range: 18-62 years) with Turner syndrome verified by karyotyping (45, X: n=58 [57%]) were included consecutively. Ambulatory BPs were recorded over 24 hours with oscillometric measurements every 20 minutes. Antihypertensive treatment was recommended if the BP was above 135/85 mm Hg during the daytime. Overall, systolic BP, diastolic BP, and pulse pressure increased during the study, while heart rate decreased. The number of patients treated with antihypertensive medicine increased from 29 (28.71%) at baseline to 34 (53.13%) at the end of study. Twenty-four-hour systolic BP and 24-hour pulse pressure increased significantly with age, while 24-hour heart rate decreased with age, and diastolic BP was insignificantly affected by age. Antihypertensive treatment lowered systolic BP (24-hour: -5 mm Hg), diastolic BP (24-hour: -5 mm Hg), and diminished the pulse pressure (24-hour: -6 mm Hg) but did not affect nighttime systolic BP. Antihypertensive treatment did not affect heart rate. Our study showed that both systolic and diastolic BP increases significantly in women with Turner syndrome resulting in an increased risk of cardiovascular comorbidities. This increment should be considered of multifactorial origin with many contributing factors which is supported by our results.
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Hypertension is three to four times more prevalent in individuals with TS than in matched controls and does not vary significantly by karyotype.
“Hypertension is three to four times more prevalent in individuals with TS than in matched controls and does not vary significantly by karyotype.450-452”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [452]
The prevalence of hypertension is as high as 20%-40% in children and up to 60% in adults with TS.
“The prevalence of hypertension is as high as 20%-40% in children441,453 and up to 60% in adults with TS.357,452,454-456”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [452]
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“Studies which have assessed the natural history of hypertension in a TS population have shown an increased prevalence of hypertension with age [41, 52].”
BackgroundApproach to the Patient With Turner Syndrome
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- Authors
- Sandahl, K., Wen, J., Erlandsen, M., Andersen, N. H., & Gravholt, C. H.
- Affiliations
- From the Department of Endocrinology and Internal Medicine and Medical Research Laboratories (K.S., J.W., C.H.G.)
- Aarhus University (DK)
- Department of Cardiology (N.H.A.)
- Aarhus University Hospital (DK)
- Venue
- Hypertension
- Published
- 2020-11
- Volume
- 76
- Issue
- 5
- Pages
- 1608-1615
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W3083926928
- Cited by
- 17
- References
- 33
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 7
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- 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, pulse pressure, antihypertensive therapy, ambulatory blood pressure monitoring, cardiovascular risk factors, heart rate, age-related blood pressure changes
- MeSH terms
- Adolescent, Adult, Antihypertensive Agents, Blood Pressure, Female, Humans, Hypertension, Middle Aged, Risk Factors, Turner Syndrome, Disease Progression, Young Adult
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