Objectives: Several case reports describe hypertension (HTN) in children treated with GnRH analogs for central precocious puberty (CPP). However, relevant data on blood pressure (BP) under GnRH analog treatment are scarce. We evaluated BP among girls with idiopathic CPP and early puberty (EP) before, during and after GnRH analog therapy, and examined associations of BP with clinical parameters.
Design: A retrospective longitudinal cohort study in a tertiary pediatric endocrinology institute.
Methods: Demographic, anthropometric, clinical and laboratory data were collected from electronic files of 112 girls treated with GnRH analog for idiopathic CPP (n = 81) or EP (n = 31) (the study group), and 37 healthy pre-pubertal controls. BP measurements from regular clinic visits were expressed as percentiles adjusted for gender, height and age. Data at baseline, under therapy and off-therapy were compared.
Results: At presentation, mean BP values were above the 50th percentile in all three subgroups; mean values of the study group did not differ significantly from those of the controls. At diagnosis, 53 patients (47%) of the study group had normal BP values, 16 (14%) had elevated BP values and 43 (39%) had values within the range defined as HTN. The mean systolic and diastolic BP percentiles at first measurement under treatment remained unchanged. After treatment cessation, the mean systolic, but not diastolic, BP percentile was lower than baseline (n = 47, P = 0.006). In the study group, girls with baseline BP >90th percentile had lower mean birthweight (P = 0.01) and a higher mean BMI-standard deviation score (P = 0.01). Girls with baseline BP >90th percentile were not different from those with BP < 90th percentile in mean age at onset of puberty, height-SDS, Tanner stage, bone age SDS, peak LH, E2, DHEA-S or androstenedione levels at diagnosis.
Conclusions: At presentation, girls with CPP and EP had BP values similar to pre-pubertal controls. BP did not change during GnRH analog therapy, but the mean systolic BP percentile decreased off-treatment. The stability of mean BP percentile during treatment is reassuring.
22 Sep 2021 - 26 Sep 2021