title: Improving detection of hypertension in girls with turner syndrome using ambulatory blood pressure monitoring.
abstract: OBJECTIVE
  Turner syndrome (TS) is associated with increased mortality due to cardiovascular disease and a dramatically higher rate of aortic dissection. The recognition and treatment of hypertension in this population is critical. We sought to assess the ability to detect blood pressure (BP) abnormalities comparing ambulatory blood pressure monitoring (ABPM) with conventional BP measurement methods. We hypothesized that ABPM would improve detection of hypertension and alter management strategies.
  
  
  METHODS
  Twenty-three girls with TS underwent BP measurements using an automated oscillometric method and a manual mercury sphygmomanometer. Twenty-four-hour ABPM was performed (Spacelabs 90217, Issaquah, Wash., USA). BP values were compared to normative data based on height and sex for ABPM, and for age, height and sex for automated oscillometric and manual measurements.
  
  
  RESULTS
  Five (22%) subjects were found to have ambulatory hypertension (3 of these with severe hypertension). Three subjects had prehypertension using ABPM measurements. Only 1 of the 5 patients with ambulatory hypertension was categorized as hypertensive using manual BP measurements. Twelve subjects (52%) had nocturnal hypertension. ABPM data led to a change in medical management of hypertensive patients with initiation of antihypertensive therapy.
  
  
  CONCLUSIONS
  ABPM is advantageous in TS, as it improves detection of hypertension, identifies those with non-dipping BP patterns, and changes medical management of patients.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Fla., USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Fudge
authors.forename: Cathrine
authors.initials: C
authors.lastname: Constantacos
authors.forename: James C
authors.initials: JC
authors.lastname: Fudge
authors.forename: Marsha
authors.initials: M
authors.lastname: Davenport
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods; D002648:Child; D002940:Circadian Rhythm; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D059785:Karyotype; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods / Q000592:standards; D014424:Turner Syndrome / Q000150:complications / Q000235:genetics / Q000503:physiopathology*; D055815:Young Adult