What is the risk of hypertension in children with congenital adrenal hyperplasia (CAH)?

Updated: Oct 06, 2020
  • Author: Thomas A Wilson, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

A study by Maccabee-Ryaboy et al of 180 pediatric patients indicated that children with CAH are more likely to experience hypertension than are children in the general population, with the incidence of hypertension varying according to sex and the type of CAH. In children with classic CAH, 55% of those who received fludrocortisone had hypertension, compared with 31% of those who did not.  Moreover, 58% of children with salt-wasting CAH had hypertension, compared with 35% of those with simple virilizing CAH. In 91% of salt-wasting males and 50% of salt-wasting females, hypertension developed prior to age 5 years, while hypertension usually occurred between the ages of 10 and 18 years in children with simple virilizing CAH. Higher hypertension rates were seen in children in whom at least three measurements of 17-hydroxyprogesterone were below 400 ng/dL, with the difference being significant in salt-wasting males. [24]


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