Table 3.
Summary of main studies investigating hypertension in CAH patients.
| Study | Patients and CAH form | Age range (years) | Mean HC dose (mg/m2/day) | Mean FC dose (μg/m2/day) | Methods | Outcomes |
|---|---|---|---|---|---|---|
| Roche et al. (21) |
-38 Classic SW | 6.1–18.2 | 17.5 (prepubertal) 17.3 (pubertal) 17.8 (postpubertal) |
120 (prepubertal) 113 (pubertal) 103 (postpubertal) |
24-h BP | ↑ BMI vs. normal population ↑ SPB and DBP vs. normal population ↓ Nocturnal dip in BP No difference between males and females |
| Bonfig et al. (22) |
-716 Classic (571 SW, 145 SV) |
3–18 | 14.4 | 72.7 | Morning BP | ↑ BMI in SW vs. SV ↑ prevalence of hypertension in 12.5% of children ↑ BP in SW vs. SV More elevated SBP than DBP At the pubertal age↑prevalence of hypertension in females than in males (12 vs. 5.3%) |
| Subbarayan et al. (25) |
-107 Classic (79 SW, 28 SV) |
0.4–20.5 | 13.3 | 102 | Mean of four measurements (every 6 h) | ↑ prevalence of obesity (23.6%) vs. normal population (14.8–17.1%) ↑ SBP vs. normal population 9.5% high plasma triglycerides No difference between males and females ↓ HOMA-IR vs. controls |
| Mooij et al. (23) |
-26 Classic (24 SW, 2 SV) |
8–16 | 11.2 | 98.5 | HOMA | ↑ BMI vs. reference population (25.9% obese and 14.8% overweight) 44.4% of patients HOMA-IR > 75th and 29.6% HOMA-IR >90th percentile ↑ SBP in 18.5%, lower than reference population 48.1% ↓ nocturnal dip |
| Akyürek et al. (43) |
-25 Classic SW -25 Controls |
5–15 | 17.03 | 120 | Morning BP 24-h BP |
↑ BMI vs. control Comparable HOMA-IR between CAH and controls ↑ DBP vs. controls ↓ Nocturnal dip of SBP and DBP vs. controls Comparable lipids between CAH and controls ↑ IMT vs. controls |
| Nebesio and Eugster (45) |
-91 Classic | n.a. | 16.4 | 90 μg/day | n.a. | ↑ prevalence of hypertension vs. normal population |
| Völkl et al. (46) |
55 Classic (45 SW, 10 SV) |
5.3–19 | 14.6 | 47 | 24-h BP | ↑ BMI ↑ daytime and nighttime SBP ↓ nocturnal dip of DBP No difference between males and females in ambulatory 24-h BP |
| Hoepffner et al. (47) |
-23 Classic | 6–17 | 18.7 | 70.8 | Morning BP 24-h BP |
↑ SPB and DBP in hospitalized vs. outpatients No difference between males and females |
| Janus et al. (27) |
-61 Classic (51 SW, 10SV) 9 Non-classic |
3–17.9 | 17.2 (SW) 19.5 (SV) 11.9 (NC) |
66.5 (SW) 28.6 (SV) |
24-h BP | Normal BMI, no differences in body composition between classic and NC forms No overt hypertension but ambulatory 24-h SBP and Night SBP were higher in females than males |
| Finkielstain et al. (8) |
-139 Classic (97 SW, 42 SV) -31 Non-classic |
0.6–17 | 15 | n.a. | n.a. | ↑ Prevalence of obesity (35%) vs. normal pediatric population (17%), with no difference between Classic and NC CAH and between males and females ↑ HOMA-IR ↑ BP (about 40% Classic and 20% NC CAH) |
CAH, Congenital Adrenal Hyperplasia; HC, hydrocortisone; FC, fludrocortisones; SW, salt wasting; BP, blood pressure; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; SV, simple virilizing; HOMA, homeostatic model assessment; HOMA-IR, HOMA insulin resistance; IMT, intima media thickness; NC, non-classic; HOMA-IS, HOMA insulin sensitivity; n.a., not available/non-applicable. ↑ increased; ↓ decreased.