title: Ambulatory blood pressure and subclinical cardiovascular disease in patients with congenital adrenal hyperplasia: a preliminary report.
abstract: OBJECTIVE
  There is an increased risk of cardiovascular morbidity in children and adolescents with classical congenital adrenal hyperplasia (CAH), presumably associated with obesity, hypertension, impaired glucose tolerance and dyslipidemia. This study was designed to evaluate the metabolic and cardiovascular profile of a group of children with classical CAH from the perspective of cardiovascular risk.
  
  
  METHODS
  Twenty-five CAH patients and 25 healthy controls were included in the study. Metabolic and anthropometric parameters were investigated and compared in these two groups.
  
  
  RESULTS
  Subjects in the CAH group were shorter than the controls (p=0.001) and had higher body mass index values (p=0.033). Diastolic blood pressure (DBP) (p=0.027) and carotid intima-media thickness (CIMT) values (p=0.006) were also higher in the patient group. In 24% (n=6) of CAH patients, 24-h ambulatory BP monitoring showed arterial hypertension. CIMT was significantly higher in the hypertensive patients than in those with no hypertension (p=0.013). Twenty percent (n=5) of CAH patients had nocturnal hypertension. CIMT was significantly greater in the nocturnal hypertensive group (p=0.02). Mean systolic BP (SBP) and DBP dipping were significantly different in the CAH patients (p<0.001). CIMT correlated negatively with DBP dipping (r=-0632, p=0.037) in these patients.
  
  
  CONCLUSIONS
  These results provide additional evidence for the presence of subclinical cardiovascular disease in classical CAH patients and its relationship with hypertension.
authors: Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Konya, Turkey. E-mail: n_akyurek@yahoo.com.tr.
authors: Nesibe
authors: N
authors: Akyürek
authors: Mehmet Emre
authors: ME
authors: Atabek
authors: Beray Selver
authors: BS
authors: Eklioğlu
authors: Hayrullah
authors: H
authors: Alp
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000473:pathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D009765:Obesity / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate