24-Hour Blood Pressure Profiles in Children with Congenital Adrenal Hyperplasia on Two Different Hydrocortisone Treatment Regimens

Abstract

To study the effect of two hydrocortisone (HC) treatment regimens on 24-h blood pressure (BP) profiles in children with congenital adrenal hyperplasia (CAH). Six patients (4 F/2 M) with the salt-wasting form of CAH, aged from 5.0-9.7 years, underwent 24-h BP monitoring on two treatment regimens: a higher HC dose in the morning (regimen A) or in the evening (regimen B). The mean 24-h systolic BP (sBP) on regimen B was more than 1 SDS higher than on regimen A (0.92 +/- 1.17 vs. -0.13 +/- 1.23, p < 0.05). The difference was seen both in daytime and night-time BP. Regimen B significantly increased sBP in four patients and diastolic BP in two patients. Mean drop in night-time sBP was 8.8% on regimen A and 8% on regimen B. Biochemical control was not different between the two regimens. The HC treatment regimen with a higher dose in the evening increased 24-h BP levels in children with CAH and did not improve biochemical control of the disease.