High steroid doses are often necessary in congenital adrenal hyperplasia (CAH) to suppress androgens and may increase blood pressure (BP). We evaluated 24-hour BP profile (ambBP), BP during exercise (excBP), and echocardiography in 20 young CAH patients. Systolic and diastolic BP during ambBP and excBP was normal in all patients. None presented myocardial hypertrophy. Nocturnal diastolic BP was affected by testosterone (P: .016, 95% CI: 0.002 to 0.021, beta = 0.01). Left ventricular mass (LVM ) was affected by height SDS (P: .007, 95% CI: 2.67 to 14.17, beta = 8.42), age (P: < .0001, 95% CI: 2.12 to 5.82, beta = 3.97), and testosterone (P: .008, 95% CI: 0.01 to 0.09, beta = 0.053). Left ventricular mass index (LVMI) correlated with BMI SDS (P: .044, 95% CI: 0.09 to 6.17, beta = 3.13) and testosterone (P: .031, 95% CI: 0.002 to 0.035, beta = 0.018). Hydrocortisone dose did not influence ambBP, excBP, or myocardial hypertrophy.