Relationship between systolic hypertension assessed by 24-hour ambulatory blood pressure monitoring and aortic diameters in young women with Turner syndrome

Yun Jeong Lee, Shin Mi Kim, Young Ah Lee, Gi Beom Kim, Choong Ho Shin, Seiwon Yang

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hypertension and its risk factors and investigated the relationship between systolic hypertension and aortic diameter in young patients with TS. Design: Observational, cross-sectional study. Patients and measurements: Forty-two patients with TS (15-35 years) who had achieved final adult heights underwent 24-h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner-specific z-scores. Results: Systolic and/or diastolic hypertension was identified in 71.4% (n = 30) of patients, as assessed by 24-hour ABPM. Twenty-eight patients (66.7%) were nondippers. Patients with systolic hypertension (n = 8, 19.0%) had a higher weight, waist circumference and HOMA-IR levels than those without hypertension (P < 0.05 for all). After adjusting for covariates, HOMA-IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aortic valve, systolic hypertension was independently related to increased aortic diameter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions: Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control.

Original languageEnglish
Pages (from-to)156-162
Number of pages7
JournalClinical Endocrinology
Volume91
Issue number1
DOIs
StatePublished - 1 Jul 2019

Fingerprint

Ambulatory Blood Pressure Monitoring
Turner Syndrome
Hypertension
Insulin Resistance
Homeostasis
Sinus of Valsalva
Waist Circumference
Echocardiography
Aorta
Dilatation
Fasting
Cross-Sectional Studies
Odds Ratio
Insulin
Morbidity
Lipids
Weights and Measures
Glucose
Mortality

Keywords

  • Turner syndrome
  • ambulatory blood pressure monitoring
  • aortic diseases
  • hypertension
  • insulin resistance

Cite this

@article{cf2fcf990e1246c5881f476f851af116,
title = "Relationship between systolic hypertension assessed by 24-hour ambulatory blood pressure monitoring and aortic diameters in young women with Turner syndrome",
abstract = "Objective: Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hypertension and its risk factors and investigated the relationship between systolic hypertension and aortic diameter in young patients with TS. Design: Observational, cross-sectional study. Patients and measurements: Forty-two patients with TS (15-35 years) who had achieved final adult heights underwent 24-h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner-specific z-scores. Results: Systolic and/or diastolic hypertension was identified in 71.4{\%} (n = 30) of patients, as assessed by 24-hour ABPM. Twenty-eight patients (66.7{\%}) were nondippers. Patients with systolic hypertension (n = 8, 19.0{\%}) had a higher weight, waist circumference and HOMA-IR levels than those without hypertension (P < 0.05 for all). After adjusting for covariates, HOMA-IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aortic valve, systolic hypertension was independently related to increased aortic diameter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions: Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control.",
keywords = "Turner syndrome, ambulatory blood pressure monitoring, aortic diseases, hypertension, insulin resistance",
author = "Lee, {Yun Jeong} and Kim, {Shin Mi} and Lee, {Young Ah} and Kim, {Gi Beom} and Shin, {Choong Ho} and Seiwon Yang",
year = "2019",
month = "7",
day = "1",
doi = "10.1111/cen.13995",
language = "English",
volume = "91",
pages = "156--162",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell Publishing Ltd",
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}

TY - JOUR

T1 - Relationship between systolic hypertension assessed by 24-hour ambulatory blood pressure monitoring and aortic diameters in young women with Turner syndrome

AU - Lee, Yun Jeong

AU - Kim, Shin Mi

AU - Lee, Young Ah

AU - Kim, Gi Beom

AU - Shin, Choong Ho

AU - Yang, Seiwon

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objective: Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hypertension and its risk factors and investigated the relationship between systolic hypertension and aortic diameter in young patients with TS. Design: Observational, cross-sectional study. Patients and measurements: Forty-two patients with TS (15-35 years) who had achieved final adult heights underwent 24-h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner-specific z-scores. Results: Systolic and/or diastolic hypertension was identified in 71.4% (n = 30) of patients, as assessed by 24-hour ABPM. Twenty-eight patients (66.7%) were nondippers. Patients with systolic hypertension (n = 8, 19.0%) had a higher weight, waist circumference and HOMA-IR levels than those without hypertension (P < 0.05 for all). After adjusting for covariates, HOMA-IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aortic valve, systolic hypertension was independently related to increased aortic diameter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions: Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control.

AB - Objective: Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hypertension and its risk factors and investigated the relationship between systolic hypertension and aortic diameter in young patients with TS. Design: Observational, cross-sectional study. Patients and measurements: Forty-two patients with TS (15-35 years) who had achieved final adult heights underwent 24-h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner-specific z-scores. Results: Systolic and/or diastolic hypertension was identified in 71.4% (n = 30) of patients, as assessed by 24-hour ABPM. Twenty-eight patients (66.7%) were nondippers. Patients with systolic hypertension (n = 8, 19.0%) had a higher weight, waist circumference and HOMA-IR levels than those without hypertension (P < 0.05 for all). After adjusting for covariates, HOMA-IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aortic valve, systolic hypertension was independently related to increased aortic diameter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions: Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control.

KW - Turner syndrome

KW - ambulatory blood pressure monitoring

KW - aortic diseases

KW - hypertension

KW - insulin resistance

UR - http://www.scopus.com/inward/record.url?scp=85065183077&partnerID=8YFLogxK

U2 - 10.1111/cen.13995

DO - 10.1111/cen.13995

M3 - Article

VL - 91

SP - 156

EP - 162

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 1

ER -