Standardizing blood pressure phenotyping in acromegaly: A practical companion to Araujo-Castro et al.

Hypertension affects nearly half of patients with acromegaly, yet current studies inconsistently report blood pressure phenotypes due to variability in the use of office, home, and ambulatory monitoring. This companion article proposes a standardized, risk-stratified approach using ambulatory and home blood pressure monitoring to classify sustained, masked, and nocturnal hypertension and to guide antihypertensive de-escalation in relation to biochemical control. The framework incorporates key timepoints-diagnosis, early post-therapy reassessment, and long-term follow-up-while emphasizing modality-specific diagnostic thresholds, dipping patterns, and cardiovascular risk profiles. Structured follow-up using periodic ambulatory blood pressure monitoring and validated home monitoring enables more precise phenotyping, optimizes treatment decisions, and improves comparability across future acromegaly cohorts.