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Premature mortality due to cardiovascular disease in hypopituitarism
1Department of Internal Medicine II, Sahlgrenska Hospital, Göteborg, Sweden.
Insights
Patients with hypopituitarism have a higher mortality rate, particularly from vascular disorders. This study suggests growth hormone deficiency may contribute to increased cardiovascular disease risk in these patients.
Area of Science:
- Endocrinology
- Cardiovascular Research
- Epidemiology
Background:
- Hypopituitarism, a condition of deficient pituitary hormone production, affects numerous physiological processes.
- Routine hormone replacement therapy is standard care for patients with hypopituitarism.
- Previous studies have suggested potential links between hypopituitarism and cardiovascular health.
Purpose of the Study:
- To investigate the long-term mortality risks in a cohort of patients with hypopituitarism.
- To identify specific causes of increased mortality, focusing on vascular and malignant diseases.
- To explore potential contributing factors to observed mortality patterns.
Main Methods:
- Retrospective analysis of 333 consecutive hypopituitarism patients diagnosed between 1956 and 1987.
- Comparison of observed mortality rates with age- and sex-matched general population data.
- Analysis of mortality causes, including vascular and malignant diseases, in relation to patient characteristics and disease etiology.
Main Results:
- Overall mortality was significantly higher in hypopituitarism patients compared to controls.
- Vascular disorder deaths were substantially increased (60 observed vs. 30.8 expected), independent of various clinical factors.
- Mortality risk from vascular disease was elevated regardless of hypopituitarism cause (adenoma vs. secondary).
- Malignant disease mortality was lower than expected (7 observed vs. 10.1 expected).
Conclusions:
- Life expectancy is reduced in individuals with hypopituitarism.
- Increased vascular mortality is a significant concern in hypopituitarism patients.
- Growth hormone deficiency is a potential contributing factor to heightened cardiovascular disease mortality.
Abstract:
333 consecutive patients with hypopituitarism diagnosed between 1956 and 1987 were retrospectively examined. The patients had been given routine replacement therapy. The overall mortality was higher than in an age and sex matched population. Deaths from vascular disorders were also significantly increased (60 [40 male, 20 female] versus 30.8 expected [23.5, 7.4 female]). The hazard function for vascular death was independent of age at diagnosis, time after diagnosis, calendar year of diagnosis, gender, degree of pituitary insufficiency, hypertension, and diabetes mellitus. Mortality risk was raised irrespective of whether hypopituitarism was due to pituitary adenoma or secondary to other diseases. 7 patients (3 male, 4 female) died from malignant diseases (expected 10.1 and 4.1, respectively). These observations indicate that life expectancy is shortened in patients with hypopituitarism. Growth-hormone deficiency could be a factor in this increased mortality from cardiovascular disease.