Blood pressure and its associations in 554 children and young people with congenital adrenal hyperplasia
Authors' conclusion
Higher BP in children with 21OHD is common and particularly pronounced at a younger age, but may not be attributable to excessive mineralocorticoid replacement. There is a need to improve our understanding of the determinants of this raised BP as well as its long-term effects.
Study context
- Population
- Children and young people younger than 20 years with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD), International CAH Registry; 52.5% females
- Participants
- 554 children6,436 visits
- Outcome
- Trend and predictors of BP (BP-SDS vs normative values)
Methodological detailsmulticentre, International CAH Registry, comparison with normative values, multiple change point analysis, directed acyclic graph-informed covariate adjustment, joint outcome regression modeling
- Multicentre
- International CAH Registry
- Comparison with normative values
- Multiple change point analysis
- Directed acyclic graph-informed covariate adjustment
- Joint outcome regression modeling
Main finding
As reported in the abstract
Systolic BP-SDS by age
Systolic BP-SDS, patients under five years (median, Q1–Q3)
1.6
Q1:0.6-Q3:2.7
Systolic BP-SDS decreasing over 5 years to
1.0
Q1:0.2-Q3:1.8
Over the 95th centile, under five years, decreasing to
31.0% decreasing to 15.0%
Observational data: associations, not effects.
Further findings
Predictors of blood pressure (BP)
- Increase in systolic BP with every 100 µg extra fludrocortisone
- 1.2 mmHg
- Lower systolic BP with renin 100µU/mL vs 1µU/mL
- 4.6 mmHg
- Higher 17OH-progesterone and androstenedione predicted lower systolic and diastolic BP
- P < 0.05
Original publication
Blood pressure and its associations in 554 children and young people with congenital adrenal hyperplasia. Eur J Endocrinol. Published 4 April 2025. doi:10.
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