Endocrine Abstracts

Introduction: Turner syndrome (TS) is a chromosomal disorder characterised by an abnormality of or a partial or complete absence of one of the X chromosomes in a phenotypic female. The TS population experience aortic dissection at a rate ten times that of the general population, for which hypertension is a modifiable risk factor. Our primary aim was to determine the frequency of hypertension in girls attending a tertiary paediatric dedicated TS clinic in the West of Scotland and to assess its association with clinical characteristics.

Methodology: Clinical data were collected from the medical records of girls attending the dedicated paediatric TS clinic at the Royal Hospital for Children Glasgow, between 1976-2023. The percentage of girls in each group (normotensive, pre-hypertensive and hypertensive) was determined. The proportion of the cohort presenting with a cardiac anomaly, renal anomaly, obesity, and preterm birth was determined for each blood pressure classification. Similarly, patients were grouped by mosaic or 45,X karyotype. Fishers’ exact test further determined any statistical significance in the prevalence of hypertension between these groups.

Results: 184 girls diagnosed with TS were included in this study with a median (range) age at time of clinic of 12 (1 week, 21 years). Of these, 38 (21%) had an existing cardiac anomaly and 48 (26%) had an existing renal anomaly. The prevalence of hypertension within this cohort was determined to be 50% (n = 92), with median age of onset at 12 years of age. Of these, 79/92 (86%) were on hormone replacement therapy with oestrogen and 86 (93%) were on growth hormone therapy. In total, 14 (15%) were prescribed antihypertensive treatment.

Discussion: There is an increased prevalence of hypertension within the paediatric TS population compared to the general paediatric population, unrelated to the other common diagnoses or standard treatments of the TS population. Age of onset in the childhood years suggests a need for the development of paediatric TS specific hypertension guidelines which currently only exist for use in patients aged 16 and above. This early management would reduce cardiovascular disease burden in this cohort.