Эндокринология и метаболический синдром

Эндокринология и метаболический синдром
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ISSN: 2161-1017

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Evaluation of Blood Pressure and Left Ventricular Parameters in Children with Classical Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency: An Egyptian Experience

Shereen Abdelghaffar, Reem Esmail, Usama Abdelaziz and Hassan Abuzaid

Background/Aims: Congenital Adrenal Hyperplasia (CAH) patients are at higher risk of systemic hypertension secondary to high steroid dose therapy. Our aim was to look for early cardiovascular changes in young CAH patients, by the analysis of BP levels and echocardiographic parameters. We aimed also to investigate the possible risk factors that may contribute to such effects. Methods: We evaluated blood pressure measurements (using international percentiles) and echocardiography in 53 CAH pediatric patients. Thirty healthy age and sex matched children were included as controls. Results: It was found that 10(18.9%) patients had elevated BP and 23(43.4%) patients had hypertension. Out of those hypertensive patients, 7 (13.2%) patients had systolic hypertension, 3 (5.6%) patients had diastolic hypertension, and 13 (24.5%) patients had combined systolic and diastolic hypertension. BP levels of CAH cases were positively correlated with Hydrocortisone doses (r=0.14, P value=0.038) and negatively correlated with 17-OH-progesterone levels (r=-0.15, P value=0.023). Our patients had myocardial hypertrophy with increased left ventricular wall thickness, greater mean LVM and LVMI. Age and hypertension were predictors of LV hypertrophy. Conclusions: The present study showed that a considerable portion of CAH patients had hypertension. Their BP levels were influenced by Glucocorticoids (GCs) doses.
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