title: Blood Pressure in a Large Cohort of Children and Adolescents With Classic Adrenal Hyperplasia (CAH) Due to 21-Hydroxylase Deficiency.
abstract: BACKGROUND
  Data on blood pressure (BP) in children and adolescents with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency are conflicting in the literature.
  
  
  METHODS
  BP data of n = 716 children and adolescents (aged 3-18 years) from a national CAH database were analyzed. BP data were adjusted for height and compared to contemporary national reference data. A systolic and diastolic BP above the 95th centile was defined as hypertensive.
  
  
  RESULTS
  Overall prevalence of hypertension was 12.5%. Prevalence of hypertension was higher in younger children than in adolescents (18.5% vs. 4.9%). Until 8 years of age, fludrocortisone dose/m(2)/day correlated significantly with BP in regression analysis (P < 0.0001). BP correlated significantly with body mass index standard deviation score (BMI-SDS) (P < 0.0001), but not with hydrocortisone dose. In patients with salt-wasting CAH, BMI-SDS and BP were significantly higher compared to patients with simple virilising CAH, P < 0.01.
  
  
  CONCLUSIONS
  Especially young CAH children seem to be at risk for-most likely transient-hypertension, since the prevalence of hypertension decreases with age. In children up to 8 years of age, the used fludrocortisone dose is a significant risk factor for hypertension. Therefore we recommend accurate measurement of BP and careful fludrocortisone dosing in children with CAH.
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Technische Universität München, Munich, Germany; walter.bonfig@lrz.tum.de.
authors.forename: Walter
authors.initials: W
authors.lastname: Bonfig
authors.affiliation: Department of Biometrics, Otto von Guericke Universität Magdeburg, Magdeburg, Germany;
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Roehl
authors.affiliation: Pediatric Endocrinology, St. Anna Kinderspital, University of Vienna, Wien/Vienna, Austria;
authors.forename: Stefan
authors.initials: S
authors.lastname: Riedl
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Universitätsklinikum Erlangen, Erlangen, Germany;
authors.forename: Helmut Günther
authors.initials: HG
authors.lastname: Dörr
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Universitätsklinikum Heidelberg, Heidelberg, Germany;
authors.forename: Markus
authors.initials: M
authors.lastname: Bettendorf
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Universitätsklinikum Münster, Münster, Germany;
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brämswig
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Universitätsklinik zu Köln, Köln/Cologne, Germany;
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schönau
authors.affiliation: Pediatric Endocrinology, Kiel, Germany;
authors.forename: Felix
authors.initials: F
authors.lastname: Riepe
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Universitätsklinikum Essen, Essen, Germany;
authors.forename: Berthold
authors.initials: B
authors.lastname: Hauffa
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany;
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Otto von Guericke Universität Magdeburg, Magdeburg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Mohnike
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000503:physiopathology*; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male
keywords: blood pressure; congenital adrenal hyperplasia; fludrocortisone; hypertension.