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Hypertension in Acromegaly in Relationship to Biochemical Control and Mortality: Global ACROSTUDY Outcomes

Greisa Vila1, Anton Luger1, Aart Jan van der Lely2

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Frontiers in Endocrinology
|December 17, 2020
PubMed

Insights

Hypertension significantly increases mortality in acromegaly patients, particularly those with cardiovascular disease (CVD). Effective management requires addressing pituitary deficiencies and CVD alongside blood pressure control.

Area of Science:

  • Endocrinology
  • Cardiology
  • Clinical Research

Background:

  • Hypertension is a key risk factor for mortality in acromegaly.
  • Surgical cure improves blood pressure, but pegvisomant (PEGV) effects on hypertension are less understood.
  • ACROSTUDY monitors long-term PEGV treatment in acromegaly.

Purpose of the Study:

  • To evaluate outcomes in acromegaly patients with hypertension treated with PEGV.
  • To identify mortality predictors in this cohort.

Main Methods:

  • Analysis of data from the ACROSTUDY surveillance study.
  • Retrospective division of 2,090 acromegaly patients into hypertension and non-hypertension subgroups.
  • Logistic regression and Kaplan-Meier analyses for mortality predictors.

Main Results:

  • 1,344 patients had hypertension; they were older, with higher BMI, diabetes, hyperlipidemia, and CVD.
  • 68 deaths occurred in the hypertension cohort versus 10 in the non-hypertension cohort.
  • Cardiovascular disease and anterior pituitary deficiencies independently predicted mortality.

Conclusions:

  • Hypertension is prevalent in acromegaly and elevates mortality risk, especially with coexisting CVD.
  • Treatment should target IGF-I normalization, pituitary deficiencies, and cardiovascular health.
  • Aggressive screening and management of CVD are crucial in acromegaly patients with hypertension.
Abstract

Keywords:
acromegalycardiovascular diseasehypertensionhypopituitarismmortalitypegvisomantprognosis

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