Prevalence and evolution of hypertension in a large Iberian cohort of patients with acromegaly.
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Araujo-Castro Marta, García-Centeno Rogelio, González Laura, Lacerda Nobre Ema, de Griné Severino Mariana, Goi Jessica, Pérez Pena Marta María, Menéndez Torre Edelmiro, Lozano Aida Claudia, Novoa-Testa Iría, Cordido Fernando, Sánchón Raúl, Guerrero-Pérez Fernando, Oliva Rodríguez Rosario, Rodríguez-Jiménez Beatriz, Ollero García María Dolores, Irigaray Echarri Ana, Simó-Servat Andreu, Moure Rodríguez María Dolores, Novo-Rodríguez Cristina, Calatayud María, Villar-Taibo Rocío, Bernabéu Ignacio, Tenorio-Jimenéz Carmen, González Molero Inmaculada, Iglesias Pedro, Blanco Concepción, Vidal-Ostos De Lara Fernando, Aulinas Anna, Asla Roca Queralt, Paja Fano Miguel, Rivera Martínez Antonio, Cardoso Luís Miguel, Marques Pedro, Giustina Andrea, Marazuela Mónica, Puig-Domingo Manel, Biagetti Betina
Аннотация
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.