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Hypertension in acromegaly and in the normal population: prevalence and determinants

Authors

  • Giovanni Vitale,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Rosario Pivonello,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Renata S. Auriemma,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Ermelinda Guerra,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Francesco Milone,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Silvia Savastano,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Gaetano Lombardi,

    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
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  • Annamaria Colao

    Corresponding author
    1. Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Italy
      Annamaria Colao, Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Via S. Pansini 5, 80131 Naples, Italy. Tel.: + 39 081 7462132; Fax: + 39 081 5465443; E-mail: colao@unina.it
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Annamaria Colao, Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Via S. Pansini 5, 80131 Naples, Italy. Tel.: + 39 081 7462132; Fax: + 39 081 5465443; E-mail: colao@unina.it

Summary

Background  The GH/IGF-I axis has a relevant role to play in the cardiovascular system but its implication in the pathogenesis of hypertension in the normal population and in acromegaly is not yet clear.

Patients and measurements  The aim of this retrospective and controlled study was to evaluate the prevalence and determinants of hypertension in 200 patients with acromegaly and 200 nonacromegalic subjects, matched for sex, age, body mass index (BMI) and smoking habits.

Results  Hypertension was found in 46% of patients and in 25% of controls (P < 0·0001), without any difference between men and women. Family history of hypertension occurred in 30% of hypertensive acromegalic patients and in 62% of hypertensive controls (P < 0·0001). In both groups, hypertensive subjects were older than normotensive subjects. Systolic (SBP) and diastolic blood pressures (DBP) in hypertensive acromegalic patients were lower and higher, respectively, than in hypertensive controls. The risk of hypertension increased with age and was higher in the patients than in the controls [hazard ratio (HR) 1·9; P = 0·0002]. Independent predictors of SBP were age and glucose in the acromegalic population, and BMI, age and glucose levels in the controls. Independent predictors of DBP were age and glucose in the patients, and BMI, age and IGF-I in the controls.

Conclusions  In acromegaly, hypertension is more frequent than in the general population, involves predominantly DBP, and occurs earlier, is not related to gender, and is less frequently related to family history of hypertension and IGF-I levels. IGF-I may have a protective role for DBP in the general population.

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