24-hour blood pressure profiles in children with congenital adrenal hyperplasia on two different hydrocortisone treatment regimens.
OBJECTIVE
To study the effect of two hydrocortisone (HC) treatment regimens on 24-h blood pressure (BP) profiles in children with congenital adrenal hyperplasia (CAH).


METHODS
Six patients (4 F/2 M) with the salt-wasting form of CAH, aged from 5.0-9.7 years, underwent 24-h BP monitoring on two treatment regimens: a higher HC dose in the morning (regimen A) or in the evening (regimen B).


RESULTS
The mean 24-h systolic BP (sBP) on regimen B was more than 1 SDS higher than on regimen A (0.92 +/- 1.17 vs. -0.13 +/- 1.23, p < 0.05). The difference was seen both in daytime and night-time BP. Regimen B significantly increased sBP in four patients and diastolic BP in two patients. Mean drop in night-time sBP was 8.8% on regimen A and 8% on regimen B. Biochemical control was not different between the two regimens.


CONCLUSIONS
The HC treatment regimen with a higher dose in the evening increased 24-h BP levels in children with CAH and did not improve biochemical control of the disease.
Liivak
Kaur
K
Department of Paediatrics, University of Tartu, Tartu, Estonia.
Tillmann
Vallo
V
D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy* / Q000503:physiopathology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D019454:Chronotherapy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D008297:Male; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone