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Relationship between systolic hypertension assessed by 24‐hour ambulatory blood pressure monitoring and aortic diameters in young women with Turner syndrome
Author(s) -
Lee Yun Jeong,
Kim Shin Mi,
Lee Young Ah,
Kim Gi Beom,
Shin Choong Ho,
Yang Sei Won
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13995
Subject(s) - ambulatory blood pressure , medicine , blood pressure , cardiology , ambulatory , turner syndrome , isolated systolic hypertension , systolic hypertension , systole , diastole
Objective Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hypertension and its risk factors and investigated the relationship between systolic hypertension and aortic diameter in young patients with TS. Design Observational, cross‐sectional study. Patients and measurements Forty‐two patients with TS (15‐35 years) who had achieved final adult heights underwent 24‐h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA‐IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner‐specific z ‐scores. Results Systolic and/or diastolic hypertension was identified in 71.4% (n = 30) of patients, as assessed by 24‐hour ABPM. Twenty‐eight patients (66.7%) were nondippers. Patients with systolic hypertension (n = 8, 19.0%) had a higher weight, waist circumference and HOMA‐IR levels than those without hypertension ( P < 0.05 for all). After adjusting for covariates, HOMA‐IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aortic valve, systolic hypertension was independently related to increased aortic diameter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control.