Prevalence and evolution of hypertension in a large Iberian cohort of patients with acromegaly.
To analyze the prevalence of hypertension in patients with acromegaly and assess the impact of acromegaly treatment on blood pressure (BP) outcomes.
Retrospective multicenter study of 434 patients with acromegaly surveilled at 25 tertiary hospitals in Spain and Portugal. The cohort was divided into two subgroups: patients with (n = 209) and without (n = 225) hypertension at the time of acromegaly diagnosis.
Of the 434 patients, 209 (48.2%) had hypertension at the time of acromegaly diagnosis. Patients with acromegaly and hypertension were older and had a higher prevalence of cardiovascular disease and risk factors. A significant BP improvement was observed 3 months after pituitary surgery, with a marked reduction of the SBP (ΔSBP - 5.0mmHg, 95%CI -2.37 to -7.61) and DBP (ΔDBP - 2.2mmHg, 95% CI -0.66 to -3.75). Over a median follow-up of 8.4 years [IQR 4.8-12.8], 16% (n = 35/218) of initially normotensive patients developed hypertension, while 14.1% (n = 27/192) of hypertensive patients achieved hypertension remission. Hypertension remission was more likely in patients taking fewer antihypertensive drugs and with higher IGF1 levels at diagnosis, and in those who had a greater decrease in GH and IGF-1 after surgery.
At the time of acromegaly diagnosis up to 50% of patients have hypertension, and around 15% of them experience hypertension remission after pituitary surgery. The probability of remission is higher in patients with milder baseline hypertension and higher IGF-1 levels and in those achieving a greater postoperative decrease of GH and IGF-1.
Retrospective multicenter study of 434 patients with acromegaly surveilled at 25 tertiary hospitals in Spain and Portugal. The cohort was divided into two subgroups: patients with (n = 209) and without (n = 225) hypertension at the time of acromegaly diagnosis.
Of the 434 patients, 209 (48.2%) had hypertension at the time of acromegaly diagnosis. Patients with acromegaly and hypertension were older and had a higher prevalence of cardiovascular disease and risk factors. A significant BP improvement was observed 3 months after pituitary surgery, with a marked reduction of the SBP (ΔSBP - 5.0mmHg, 95%CI -2.37 to -7.61) and DBP (ΔDBP - 2.2mmHg, 95% CI -0.66 to -3.75). Over a median follow-up of 8.4 years [IQR 4.8-12.8], 16% (n = 35/218) of initially normotensive patients developed hypertension, while 14.1% (n = 27/192) of hypertensive patients achieved hypertension remission. Hypertension remission was more likely in patients taking fewer antihypertensive drugs and with higher IGF1 levels at diagnosis, and in those who had a greater decrease in GH and IGF-1 after surgery.
At the time of acromegaly diagnosis up to 50% of patients have hypertension, and around 15% of them experience hypertension remission after pituitary surgery. The probability of remission is higher in patients with milder baseline hypertension and higher IGF-1 levels and in those achieving a greater postoperative decrease of GH and IGF-1.
Authors
Araujo-Castro Araujo-Castro, García-Centeno García-Centeno, González González, Lacerda Nobre Lacerda Nobre, de Griné Severino de Griné Severino, Goi Goi, Pérez Pena Pérez Pena, Menéndez Torre Menéndez Torre, Lozano Aida Lozano Aida, Novoa-Testa Novoa-Testa, Cordido Cordido, Sánchón Sánchón, Guerrero-Pérez Guerrero-Pérez, Oliva Rodríguez Oliva Rodríguez, Rodríguez-Jiménez Rodríguez-Jiménez, Ollero García Ollero García, Irigaray Echarri Irigaray Echarri, Simó-Servat Simó-Servat, Moure Rodríguez Moure Rodríguez, Novo-Rodríguez Novo-Rodríguez, Calatayud Calatayud, Villar-Taibo Villar-Taibo, Bernabéu Bernabéu, Tenorio-Jimenéz Tenorio-Jimenéz, González Molero González Molero, Iglesias Iglesias, Blanco Blanco, Vidal-Ostos De Lara Vidal-Ostos De Lara, Aulinas Aulinas, Asla Roca Asla Roca, Paja Fano Paja Fano, Rivera Martínez Rivera Martínez, Cardoso Cardoso, Marques Marques, Giustina Giustina, Marazuela Marazuela, Puig-Domingo Puig-Domingo, Biagetti Biagetti
View on Pubmed