Blood pressure in adults with short stature skeletal dysplasias.
Julie Elizabeth Hoover-FongAdekemi Yewande AladeMichael AinIvor BerkowitzMichael BoberErin CarterJacqueline HechtDan HoerschemeyerDebra KrakowGretchen MacCarrickWilliam G MackenzieRoberto MendozaEricka OkenfussDeirdre PopplewellCathleen RaggioKerry SchulzeJohn McGreadyPublished in: American journal of medical genetics. Part A (2019)
Hypertension, compounded by obesity, contributes to cardiovascular disease and mortality. Data describing hypertension prevalence in adults with short stature skeletal dysplasias are lacking, perhaps due to poor fit of typical adult blood pressure cuffs on rhizomelic or contracted upper extremities. Through health screening research, blood pressure was measured in short stature adults attending support group meetings and skeletal dysplasia clinics. Blood pressure was measured with a commercially available, narrower adult cuff on the upper and/or lower segment of the arm. Height, weight, age, gender, diagnosis, exercise, and medications were collected. Subjects were classified as normotensive, prehypertensive, or hypertensive for group analysis; no individual clinical diagnoses were made. In 403 short stature adults, 42% were hypertensive (systolic >140, diastolic >90 OR taking antihypertensive medications). For every BMI unit and 1 kg weight increase in males, there was a 9% and an 8% increase, respectively, in the odds of hypertension versus normotension. In females, the increase was 10% and 6%, respectively. In those with achondroplasia, the most common short stature dysplasia, males (n = 106) had 10% greater odds of hypertension versus normotension for every BMI unit and kilogram increase. In females with achondroplasia (n = 128), the odds of hypertension versus normotension was 8% greater for each BMI unit and 7% for each additional kilogram. These data suggest a high population prevalence of hypertension among short stature adults. Blood pressure must be monitored as part of routine medical care, and measuring at the forearm may be the only viable clinical option in rhizomelic short stature adults with elbow contractures.
Keyphrases
- blood pressure
- hypertensive patients
- body mass index
- heart rate
- growth hormone
- cardiovascular disease
- weight gain
- weight loss
- risk factors
- physical activity
- healthcare
- primary care
- public health
- mental health
- blood glucose
- heart failure
- electronic health record
- cardiovascular events
- machine learning
- skeletal muscle
- cardiovascular risk factors
- tertiary care
- high fat diet induced