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The interplay between prolactin and cardiovascular disease.

Andrea Glezer1,2, Mariana Ramos Santana1, Marcello D Bronstein1,2

  • 1Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, SP, Brazil.

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PubMed
Summary

Hyperprolactinemia may increase cardiovascular disease (CVD) risk, particularly in men. Dopamine agonist treatment shows potential benefits for vascular health in patients with prolactinoma.

Keywords:
cardiovascular riskdopaminergic agonistdyslipidemiahyperglycemiametabolic syndromeprolactinprolactinomasystemic arterial hypertension

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Disorders

Background:

  • Hyperprolactinemia's effects on the hypothalamic-pituitary-gonadal axis are known.
  • Emerging evidence suggests a link between hyperprolactinemia and increased cardiovascular disease (CVD) risk.
  • Conflicting data exists regarding prolactin (PRL) levels and CVD risk or mortality.

Purpose of the Study:

  • To investigate the association between hyperprolactinemia and cardiovascular disease (CVD) risk.
  • To explore the metabolic effects of hyperprolactinemia and dopamine agonist (DA) treatment on vascular parameters.
  • To elucidate potential mechanisms linking hyperprolactinemia to CVD.

Main Methods:

  • Review of existing studies on hyperprolactinemia, prolactinoma, and CVD risk.
  • Analysis of data on lipid profiles, endothelial function, and inflammatory markers in patients on DA treatment.
  • Examination of correlations between prolactin levels, blood pressure, arterial function, and metabolic markers.

Main Results:

  • Dopamine agonist (DA) treatment in men with prolactinoma decreased total and LDL-cholesterol.
  • DA treatment also showed potential benefits like increased HDL, decreased triglycerides, and improved endothelial function.
  • Hyperprolactinemia was associated with increased blood pressure and impaired endothelial function, while DA withdrawal worsened vascular parameters.

Conclusions:

  • Hyperprolactinemia is linked to impaired endothelial function and potentially increased CVD risk.
  • Dopamine agonist treatment may improve vascular parameters and reduce CVD risk in hyperprolactinemic patients.
  • Further research is needed to confirm CVD risk in hyperprolactinemic patients and guide treatment decisions beyond hypogonadism.