Clinical Endocrinology. 2019;00:1–7. wileyonlinelibrary.com/journal/cen | 1 © 2019 John Wiley & Sons Ltd Received: 2 February 2019 | Revised: 15 April 2019 | Accepted: 15 April 2019 DOI: 10.1111/cen.13995 ORIGINAL ARTICLE Relationship between systolic hypertension assessed by 24‐hour ambulatory blood pressure monitoring and aortic diameters in young women with Turner syndrome Yun Jeong Lee | Shin Mi Kim | Young Ah Lee | Gi Beom Kim | Choong Ho Shin | Sei Won Yang Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Correspondence Young Ah Lee, Department of Pediatrics, Seoul National University Children’s Hospital, 101 Daehak‐ro, Jongno‐gu, Seoul 03080, Korea. Email: nina337@snu.ac.kr Funding information Seoul National University Hospital, Grant/ Award Number: 04‐2014‐3080 Abstract Objective: Patients with Turner syndrome (TS) are at high risk for cardiovascular morbidity and mortality due to aortic dilation. We evaluated the prevalence of hy‐ pertension and its risk factors and investigated the relationship between systolic hy‐ pertension and aortic diameter in young patients with TS. Design: Observational, cross‐sectional study. Patients and measurements: Forty‐two patients with TS (15‐35 years) who had achieved final adult heights underwent 24‐h ambulatory blood pressure monitoring (ABPM). Fasting glucose, insulin and lipid profiles were measured. The homeostasis model assessment of insulin resistance (HOMA‐IR) was calculated. Echocardiography was performed to evaluate aortic diameters (aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction and ascending aorta), which were converted into Turner‐specific z‐scores. Results: Systolic and/or diastolic hypertension was identified in 71.4% (n = 30) of patients, as assessed by 24‐hour ABPM. Twenty‐eight patients (66.7%) were nondip‐ pers. Patients with systolic hypertension (n = 8, 19.0%) had a higher weight, waist cir‐ cumference and HOMA‐IR levels than those without hypertension (P < 0.05 for all). After adjusting for covariates, HOMA‐IR was independently associated with systolic hypertension (odds ratio 10.1, P = 0.043). After adjusting for age and bicuspid aor‐ tic valve, systolic hypertension was independently related to increased aortic diam‐ eter at the aortic annulus (β = 1.064, P = 0.009) and sinotubular junction (β = 1.124, P = 0.016). Conclusions: Hypertension is highly prevalent and independently associated with IR in young patients with TS. The significant relationship between systolic hypertension and aortic diameters underscores the importance of BP and IR control. KEYWORDS ambulatory blood pressure monitoring, aortic diseases, hypertension, insulin resistance, Turner syndrome