Findings suggest BP 'awareness gap' in Turner syndrome

By Anne Harding

NEW YORK (Reuters Health) - High blood pressure (BP) often goes unrecognized in girls with Turner syndrome, and is more common in those with obesity or a history of aortic coarctation, according to new research.

"Targeting modifiable risk factors (obesity), intensive surveillance of high-risk subgroups (history of aortic coarctation) and early and intensive treatment of hypertension has the potential to reduce the burden of cardiovascular disease in Turner syndrome," Dr. Evan Los of Oregon Health & Science University in Portland, who worked on the study, told Reuters Health by email.

The findings were published online May 23 in Hypertension.

Turner syndrome, in which a female is born missing all or part of one X chromosome, leads to a shorter lifespan, chiefly due to cardiovascular disease, Dr. Los explained. "High blood pressure is common in Turner syndrome and is the most easily treatable cardiovascular risk factor," he added.

To better understand factors associated with high BP in Turner syndrome, Dr. Los and his team studied 168 girls aged 2 to 17 years who attended the Turner Syndrome Society of the United States' annual meeting over a nine-year period.

While 42% had elevated screening BP, only 8% reported having been diagnosed with hypertension previously.

Girls who had undergone aortic coarctation repair (17%) were significantly more likely to have elevated systolic BP (52% vs. 32%). High systolic BP was also significantly more common in the 19% of study participants who were obese (56% vs. 31%).

"Our results strongly suggest there is a BP awareness gap in Turner syndrome," Dr. Los and his team write. "This is likely because of a combination of factors, including inadequate screening, lack of appreciation for the significant health risks posed by hypertension once it is diagnosed, and inadequate treatment or follow-up."

The obesity rate in the study participants was similar to that in the general population, the researchers note, suggesting that Turner syndrome in and of itself increases hypertension risk.

"Differential susceptibility to common disorders can teach us about underlying causes and risks," Dr. Los noted. "Males have higher rates of hypertension than females; understanding the intrinsic causes for hypertension in Turner syndrome may provide clues as to why a second X-chromosome may be protective against hypertension."

SOURCE: http://bit.ly/1t3PYBg

Hypertension 2016.

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