title: Ambulatory arterial stiffness index in Turner syndrome: the impact of sex hormone replacement therapy.
abstract: BACKGROUND
  Morbidity and mortality from congenital and acquired cardiovascular (CV) disease is increased in Turner syndrome (TS), where traditional indices of CV risk are widely present but the single most common feature remains estrogen deficiency.
  
  
  OBJECTIVE
  To investigate CV risk in TS as expressed by the widely available ambulatory arterial stiffness index (AASI) and the impact of female sex hormone replacement therapy (HRT) hereon.
  
  
  METHODS
  TS women (n = 26) were examined following HRT washout and again during 6 months of HRT. Age-matched healthy female controls (n = 24) were examined once. 24-Hour ambulatory blood pressures, AASI in addition to metabolic and anthropometric indices of CV risk were measured.
  
  
  RESULTS
  The relatively tachycardic TS women had higher systolic and diastolic blood pressures. HRT reduced diastolic blood pressures with an increase in physical fitness, worsening of glucose tolerance, and a reduction in high-density lipoprotein. AASI was significantly elevated in TS when compared to controls (0.36 (0.02) vs. 0.26 (0.03), p = 0.01) but unaffected by HRT. Major explanatory variables to AASI were status (being TS or not), age, and diurnal pulse variability.
  
  
  CONCLUSIONS
  AASI was elevated in TS, possibly indicating elevated CV risk with no impact of short-term HRT.
authors.affiliation: Medical Department M (Endocrinology and Diabetes) and Medical Research Laboratories, Aarhus University Hospital NBG, Aarhus University Hospital, DK-8000 Aarhus, Denmark. kristian.havmand@ki.au.dk
authors.forename: Kristian H
authors.initials: KH
authors.lastname: Mortensen
authors.forename: Klavs W
authors.initials: KW
authors.lastname: Hansen
authors.forename: Mogens
authors.initials: M
authors.lastname: Erlandsen
authors.forename: Jens S
authors.initials: JS
authors.lastname: Christiansen
authors.forename: Claus H
authors.initials: CH
authors.lastname: Gravholt
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D012306:Risk; D014424:Turner Syndrome / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D014655:Vascular Resistance