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Observation of hypertension in children with 21-hydroxylase deficiency: a preliminary report

Todd D Nebesio1, Erica A Eugster

  • 1Department of Pediatrics, Section of Pediatric Endocrinology/Diabetology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA. tdnebesi@iupui.edu

Endocrine
|May 29, 2007
PubMed

Insights

Hypertension (HTN) is more common in children with 21-hydroxylase deficiency (21OHD) than previously thought. Elevated BMI did not predict HTN development in this pediatric endocrine disorder.

Area of Science:

  • Pediatric Endocrinology
  • Genetics and Genetic Diseases
  • Cardiovascular Health

Background:

  • 21-hydroxylase deficiency (21OHD) is the primary cause of congenital adrenal hyperplasia.
  • The prevalence and risk factors for hypertension (HTN) in pediatric patients with 21OHD remain largely uncharacterized.
  • Obesity is a known risk factor for HTN in the general pediatric population, prompting investigation into its role in 21OHD.

Purpose of the Study:

  • To determine the prevalence of hypertension in children diagnosed with 21-hydroxylase deficiency.
  • To investigate whether elevated body mass index (BMI) is a predictive factor for the development of hypertension in this cohort.
  • To compare the observed HTN prevalence in children with 21OHD to historical pediatric data.

Main Methods:

  • Retrospective chart review of pediatric patients with 21OHD treated at pediatric endocrine clinics over a 21-year period.
  • Identification of patients diagnosed with 21OHD and assessment for the presence of hypertension.
  • Analysis of body mass index (BMI) as a potential predictor for hypertension development.

Main Results:

  • A total of 91 children with 21OHD were included in the study.
  • Six patients (6.6%) were diagnosed with hypertension, with five (5.6%) having essential hypertension.
  • Elevated BMI was not found to be a significant determining factor in the development of HTN among these children.

Conclusions:

  • Children with 21OHD exhibit a higher prevalence of hypertension compared to historical pediatric population data.
  • Elevated BMI is not a predictive factor for HTN in children with 21OHD.
  • The co-occurrence of HTN with salt-wasting and mineralocorticoid deficiency in some 21OHD patients presents a paradoxical clinical picture requiring further etiological investigation.

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