SFEBES2023 Oral Poster Presentations Reproductive Endocrinology (4 abstracts)
Are we giving enough attention to blood pressure control in turner syndrome? : Data from the international turner syndrome (I-TS) registry
Shani A.D. Mathara Diddhenipothage 1 , Katharina J. Beck 1 , C G K Amiyangoda 1 , Jillian Bryce 2 , Luminita Cima 3 , Katya De Groote 4 , Yana Deyanova 5 , Evgenia Globa 6 , Gloria Herrmann 7 , Anders Juul 8,9 , Anna Sophie L. Kjaer Kjaer 8 , Anette Tønnes Pedersen 10,9 , Sukran Poyrazoglu 11 , Ursina Probst-Scheidegger 12 , Theo C.J. Sas 13,14 , Simona Fica 3 , Sumudu Nimali Seneviratne 15 , Justyna Karolina Witczak 16 , Elizabeth Orchard 17 , Jeremy W. Tomlinson 18 , S. Faisal Ahmed 2 & Helen E Turner 1
1Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Trust, Oxford, United Kingdom. 2Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Royal Hospital For Children, Glasgow, United Kingdom. 3Endocrinology Department Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 4Department of Pediatrics, Paediatric cardiology, Ghent University Hospital, Ghent, Belgium. 5Department of Pediatrics, Medical University of Varna, Varna, Bulgaria. 6Department of pediatric endocrinology, Ukrainian Research Center of Endocrine Surgery, Endocrine Organs and Tissue Transplantation, Kyiv, Ukraine. 7Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetes, University Hospital Ulm, Ulm, Germany. 8Department of Growth and Reproduction and EDMaRC, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark. 9Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 10Department of Gynecology, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 11Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 12Pediatric Department, Kantonsspital Winterthur, Winterthur, Switzerland. 13Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, Netherlands. 14Diabeter, Center for pediatric and adult diabetes care and research, Rotterdam, Netherlands. 15Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. 16Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Cardiff, United Kingdom. 17Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. 18Oxford Centre for Diabetes, Endocrinology, and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
Introduction: Cardiovascular disease is the commonest cause of death (absolute-excess-risk:41%) in Turner Syndrome (TS). Hypertension is a major risk for circulatory-disease (up to 60%) and a key modifiable-risk factor of aortopathy, ischemic heart disease and stroke in TS. There is no current consensus for hypertension diagnosis/management in TS.
Methods: Retrospective multi-centre observational study of patients aged ≥18 years, included in the I-TS registry (2020-2022) utilising registry and participating centre collected data.
Results: Eleven international-centres participated, including 184 patients; [median age 28 (range 18-71) years]. Hypertension was recorded in 13% (24/184) with median age 27(range 10-56) years, systolic-blood pressur(SBP) 150 (range 125-270)mmHg, and diastolic-BP(DBP) 90(range 60-136)mmHg at diagnosis. Hypertension was diagnosed in 69.2% aged ≤40 years and 92.3% aged ≤50 years. Karyotype 45,X (P=0.024) was significantly associated with hypertension (Table 1). Age of estrogen comencement (P=0.508), daily estrogen (P=0.719) and progesterone (P=0.352) doses, and route of HRT (P=0.568) were not associated with hypertension. None of TS-specific-comorbidities [aortic disease: 39.1% (P=0.125), renal anomalies: 20.8% (P=0.585)], nor TS-associated-morbidities [dyslipidaemia: 40% (P=0.14)], were associated with hypertension. Hypertension control was suboptimal; 38.1% and 52.6% respectively had SBP and DBP above 130/80 mmHg, including 50% (4/8) of patients with aortopathy. Management included angiotensin-converting-enzyme inhibitors (ACEi) (62.5%), angotensin-receptor-blockers(25%) and beta-blockers(25%).
| Characteristic | Hypertension | No hypertension | P values |
| Median age at data collection | 45 (range 18-67) years | 28 (range 18-71) years | 0.012 |
| Body-mass-index | 28.4 (range 20.6-43.9) Kg/m2 | 24 (range 14.2-34.5 Kg/m2 | 0.005 |
| Monosomy, 45,X | 15 (62.5%) | 61(38.1%) | 0.024 |
Conclusions: Hypertension was common in TS. Young-onset disease with high prevalence of TS-specific/associated morbidity was observed. Overweight/obesity and 45,X karyotype were notable risk factors for hypertension. The frequency of sub-optimal BP control highlights the importance of increased awareness and TS-specific consensus guidance on management.
Volume 94
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