199 Challenges in identification of hypertension in children and young people with Turner Syndrome

<h3>Aims</h3> Hypertension (HTN) can develop at a young age in Turner Syndrome (TS), and International Guidelines recommend that blood pressure (BP) is measured at every clinic visit during childhood.¹ Measurements of BP and clinical interpretation were audited to assess compliance with these guidelines. <h3>Methods</h3> The most recent evaluable BP measurement was identified in the medical records of all girls diagnosed with TS in a tertiary centre in October 2021. BP percentiles were calculated using gender, age, and height matched BP percentile charts.² True BP (tBP) percentile was compared to a hypothetical BP (hBP) percentile based on an age expected height at the 50^th percentile. We defined a systolic and/or diastolic BP value ≥95th BP percentile as an indication for further investigation. <h3>Results</h3> 33 girls were included. Median age was 12.9 years (range 2.3-17.6). 78.8% had at least one evaluable BP, and 38.5% of these were from the last clinic visit. Evaluation of BP in clinic resulted in referral and subsequent diagnosis for HTN in two girls; however, tBP percentiles suggested an additional 9 patients in our cohort warranted further investigation. Even hBP percentiles indicated that the BP values of 4 patients should be investigated further. (table 1) <h3>Conclusion</h3> In paediatric patients with TS the use of BP percentile calculators where age, height, and gender are mandatory variables, should be encouraged. If height is not available, estimating it at 50^th percentile will identify some (but not all) hypertensive TS girls. <h3>References</h3> European Journal of Endocrinology, Gravholt CH, et al. Pediatrics, Flynn JT, et al.