title: Adult patients with congenital adrenal hyperplasia have elevated blood pressure but otherwise a normal cardiovascular risk profile.
abstract: OBJECTIVE
  Treatment with glucocorticoids and mineralocorticoids has changed congenital adrenal hyperplasia (CAH) from a fatal to a chronic lifelong disease. Long-term treatment, in particular the chronic (over-)treatment with glucocorticoids, may have an adverse effect on the cardiovascular risk profile in adult CAH patients. The objective of this study was to evaluate the cardiovascular risk profile of adult CAH patients.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  In this case-control study the cardiovascular risk profile of 27 adult CAH patients and 27 controls, matched for age, sex and body mass index was evaluated by measuring ambulatory 24-hour blood pressure, insulin sensitivity (HOMA-IR), lipid profiles, albuminuria and circulating cardiovascular risk markers (PAI-1, tPA, uPA, tPA/PAI-1 complex, hsCRP, adiponectin, IL-6, IL-18 and leptin).
  
  
  RESULTS
  24-Hour systolic (126.3 mmHg±15.5 vs 124.8 mmHg±15.1 in controls, P = 0.019) and diastolic (76.4 mmHg±12.7 vs 73.5 mmHg±12.4 in controls, P<0.001) blood pressure was significantly elevated in CAH patients compared to the control population. CAH patients had higher HDL cholesterol levels (P<0.01), lower hsCRP levels (P = 0.03) and there was a trend toward elevated adiponectin levels compared to controls. Other cardiovascular risk factors were similar in both groups.
  
  
  CONCLUSIONS
  Adult CAH patients have higher ambulatory blood pressure compared to healthy matched controls. Other cardiovascular risk markers did not differ, while HDL-cholesterol, hsCRP and adiponectin levels tended to be more favorable.
authors: Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. c.mooij@cukz.umcn.nl
authors: Christiaan F
authors: CF
authors: Mooij
authors: Jeanne Margot
authors: JM
authors: Kroese
authors: Fred C G J
authors: FC
authors: Sweep
authors: Ad R M M
authors: AR
authors: Hermus
authors: Cees J
authors: CJ
authors: Tack
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D000328:Adult; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D007328:Insulin; D008055:Lipids