Blood pressure and Turner syndrome

Nathwani, Nitya; Unwin, Robert J.; Brook, C. G. D.; Hindmarsh, Peter C.

doi:10.1046/j.1365-2265.2000.00960.x

Cited by 120 publications

(86 citation statements)

References 34 publications

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“…In agreement with other reports, we showed a higher prevalence of hypertension in our patients, although lower than that estimated by epidemiological studies (7). Furthermore, the 24 h ambulatory blood pressure monitoring revealed a loss of nocturnal reduction in blood pressure suggestive of a diagnosis of arterial hypertension in patients otherwise considered normotensive by single ambulatory blood pressure evaluation.…”

Section: Discussionsupporting

confidence: 79%

“…Furthermore, the 24 h ambulatory blood pressure monitoring revealed a loss of nocturnal reduction in blood pressure suggestive of a diagnosis of arterial hypertension in patients otherwise considered normotensive by single ambulatory blood pressure evaluation. The exact mechanism of hypertension in TS has not been clearly identified: an increase in plasma renin activity has been found in 50% of cases by some authors and abnormal vagosympathetic tone, explaining relative tachycardia, has recently been described (7). As hypertension is an important risk factor for cardiovascular complications, it is important that TS patients undergo 24 h ambulatory blood pressure monitoring to detect the presence of hypertension that would be missed by a single blood pressure measurement.…”

Section: Discussionmentioning

confidence: 99%

“…Since the description of TS by Henry H Turner in 1938 (2), a wealth of information has been added and our current understanding of the syndrome is continuously being broadened. It has long been known that left-sided congenital cardiac abnormalities are more prevalent in women with TS, and recent studies have demonstrated that these women have a threefold increase in mortality, primarily as a results of cardiovascular complications (3)(4)(5)(6), and several risk factors for ischemic heart disease including hypertension (4,7), insulin resistance (8)(9)(10), and hyperlipidemia (10,11).…”

Section: Introductionmentioning

confidence: 99%

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Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy

Giordano¹,

Forno²,

Lanfranco³

et al. 2011

European Journal of Endocrinology

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Objective: Turner's syndrome (TS) is a rare genetic disorder caused by complete or partial X chromosome monosomy in a phenotypic female, and it is associated with increased morbidity and mortality for cardiovascular diseases, impaired glucose tolerance, and dyslipidemia. Subjects and methods: In 30 adult TS patients under chronic hormonal replacement therapy (HRT), 17b-estradiol (E 2 ), body mass index (BMI), waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test (OGTT), 24 h ambulatory blood pressure monitoring (ABPM), and intima-media thickness (IMT) were evaluated and compared with those in 30 age-and sex-matched controls (CS). Results: No difference was found between TS and CS in E 2 and BMI, whereas waist circumference was higher (P!0.05) in TS (77.7G2.5 cm) than in CS (69.8G1.0 cm). Fasting glucose in TS and in CS was similar, whereas fasting insulin, HOMA index, and 2 h glucose after OGTT were higher (P!0.0005) in TS (13.2G0.8 mUI/l, 2.5G0.2, and 108.9G5.5 mg/dl respectively) than in CS (9.1G0.5 mUI/l, 1.8G0.1, and 94.5G3.8 mg/dl respectively). Total cholesterol was higher (P!0.05) in TS (199.4G6.6 mg/dl) than in CS (173.9G4.6 mg/dl), whereas no significant differences in highdensity lipoprotein, low-density lipoprotein, and triglycerides were found between the two groups. In 13% of TS, ABPM showed arterial hypertension, whereas IMT was !0.9 mm in all TS and CS. A negative correlation between insulin levels, HOMA index, or 2 h glucose after OGTT and E 2 was present in TS. Conclusions: Our results indicate that adult patients with TS under HRT are connoted by higher frequency of central obesity, insulin resistance, hypercholesterolemia, and hypertension.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy

Giordano¹,

Forno²,

Lanfranco³

et al. 2011

European Journal of Endocrinology

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“…Thirty percent of girls with Turner syndrome are mildly hypertensive on 24-h ambulatory blood pressure monitoring, and 50% have an abnormal diurnal blood pressure profile (172). Women with Turner syndrome have significantly elevated blood pressure compared with an age-matched control group (188), and as many as 50% have clinical hypertension (312,321).…”

Section: Hypertension and Ischemic Heart Diseasementioning

confidence: 99%

Epidemiological, endocrine and metabolic features in Turner syndrome

2004

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Turner syndrome is one of the more common genetic disorders, associated with abnormalities of the X chromosome, and occurring in about 50 per 100 000 liveborn girls. Turner syndrome is usually associated with reduced adult height, gonadal dysgenesis and thus insufficient circulating levels of female sex steroids, and infertility. A number of other signs and symptoms are seen more frequently with the syndrome. Morbidity and mortality are increased. The average intellectual performance is within the normal range. A number of recent studies have provided new insights with respect to epidemiology, cardiology, endocrinology and metabolism. Treatment with GH during childhood and adolescence allows a considerable gain in adult height, although verylong-term consequences of this treatment are not clear. Puberty has to be induced in most cases, and female sex hormone replacement therapy is given during the adult years. The proper dose of hormone replacement therapy (HRT) has not been established, and, likewise, benefits and/or drawbacks from HRT have not been thoroughly evaluated. Since the risk of cardiovascular and endocrinological disease is clearly elevated, proper care during adulthood is emphasized. In summary, Turner syndrome is a condition associated with a number of diseases and conditions which are reviewed in the present paper.

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“…Systemic hypertension affects 30% of TS patients regardless of age, and no specific cause can be identified in a majority of women [37]. The hypertension can often be nocturnal with decreased sympathovagal balance or tone and elevated N-terminal pro-BNP in comparison with controls, indicative of discrete systolic or diastolic dysfunction [38].…”

Section: Balkan Journal Of Medical Geneticsmentioning

confidence: 99%

Cardiovascular Disorders of Turner's Syndrome: A Review

Yuan

Hua

2010

Balkan Journal of Medical Genetics

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Cardiovascular Disorders of Turner's Syndrome: A ReviewA series of cardiovascular abnormalities may be associated with Turner's Syndrome (TS). Over 50% of the reported cardiovascular malformations have been bicuspid aortic valve or coarctation of the aorta alone. or in a combination, which may lead to a higher risk for infective endocarditis. Isolated dilation of the ascending aorta was often seen in TS, while aortic dissection has been increasingly observed in recent years. The aortic root dilation was found more likely to be due to a mesenchymal defect rather than atherosclerotic changes. Women with TS are often hypertensive as a result of aortic abnormality or renal vascular disorder. They have an increased risk of developing neoplasms, such as gonadoblastoma and dysgerminoma, and therefore they may require regular monitoring while receiving hormone therapy. In patients with gonadal dysgenesis, exogenous estrogen treatment poses a problem of connective tissue disorders of the great vessels. To resolve the contradiction between exogenous estrogen therapies and the hold-up of the progression of the connective tissue abnormality is a topic to be coped with. Careful clinical assessment is mandatory in the evaluation of patients with TS with cardiovascular abnormalities.

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Blood pressure and Turner syndrome

Cited by 120 publications

References 34 publications

Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy

Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy

Epidemiological, endocrine and metabolic features in Turner syndrome

Cardiovascular Disorders of Turner's Syndrome: A Review

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