Normal ambulatory blood pressure in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therapy

• Published in: Archives of Endocrinology and Metabolism Vol. 67; no. 1; pp. 64 - 72
• Main Authors: Borges, Juliano Henrique, Camargo, Daniela Albiero, Sewaybricker, Leticia Esposito, Santoro, Renata Isa, Oliveira, Daniel Minutti de, Lemos-Marini, Sofia Helena Valente de, Geloneze, Bruno, Guerra-Júnior, Gil, Gonçalves, Ezequiel Moreira
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Endocrinologia e Metabologia 18.01.2023; Brazilian Society of Endocrinology and Metabolism
• Subjects: Adolescent; Adrenal Hyperplasia, Congenital - complications; Adrenal Hyperplasia, Congenital - drug therapy; Adult; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Cardiovascular risk; Case-Control Studies; congenital adrenal hyperplasia; Female; Glucocorticoids - therapeutic use; Humans; hydrocortisone; Hypertension; Male; Original; Steroid 21-Hydroxylase; Young Adult; hydrocortisone; hypertension; congenital adrenal hyperplasia; Cardiovascular risk
• ISSN: 2359-3997; 2359-4292
• DOI: 10.20945/2359-3997000000504

Herein, we compared ambulatory blood pressure (ABP) between young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency and a control group. Additionally, we analyzed correlations between the glucocorticoid dose and androgen levels and ABP parameters. This case-control study included 18 patients (6 males and 12 females) and 19 controls (8 males and 11 females) matched by age (18-31 years). ABP monitoring was used to estimate blood pressure (BP) over a 24-h period. No difference was noted between patients and controls in terms of systolic BP (males, 115.5 ± 5.6 117.0 ± 9.3, = 0.733; and females, 106.4 ± 7.9 108.4 ± 7.6, = 0.556, respectively) and diastolic BP during 24 h (males, 62.8 ± 7.5 66.2 ± 5.6, = 0.349; and females, 62.7 ± 4.9 62.3 ± 4.9, = 0.818, respectively). Systolic and diastolic BP and pulse pressure during daytime and nocturnal periods were similar between patients and controls. Furthermore, no differences were detected in the percentage of load and impaired nocturnal dipping of systolic and diastolic BP between patients and controls during the 24-h period. Additionally, the glucocorticoid dose (varying between = -0.24 to 0.13, > 0.05) and androgens levels (varying between = 0.01 to 0.14, > 0.05) were not associated with ABP parameters. No signs of an elevated risk for hypertension were observed based on ABP monitoring in young adults with CAH attributed to 21OHase deficiency undergoing glucocorticoid replacement therapy.