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Cardiovascular function and glucocorticoid replacement in patients with hypopituitarism
F P Dunne1, P Elliot, M D Gammage
1Department of Medicine, University of Birmingham, Queen Elizabeth Hospital, UK.
Clinical Endocrinology
|November 1, 1995
Summary
Hypopituitary adults showed no cardiovascular dysfunction, with lower blood pressure potentially offering protection. Reducing hydrocortisone (HC) dose was safe but provided no significant short-term clinical benefit for cardiovascular parameters.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Internal Medicine
Background:
- Adult growth hormone (GH) deficiency in hypopituitarism is linked to increased cardiovascular disease mortality.
- High-dose glucocorticoid replacement, such as 30 mg/day hydrocortisone (HC), may contribute to cardiovascular risks in these patients.
Purpose of the Study:
- To compare cardiovascular function in hypopituitary patients on standard HC therapy versus controls.
- To investigate if reducing HC dosage improves cardiovascular parameters in hypopituitary adults.
Main Methods:
- Prospective analysis of 13 hypopituitary patients and 20 matched controls.
- Assessed 24-hour ambulatory blood pressure, BP responses, echocardiography, and cardiovascular reflexes.
- Evaluated parameters at HC 30 mg/day and after 3 months on HC 15 mg/day.
Main Results:
- Hypopituitary patients had lower blood pressure than controls, with no significant change after HC dose reduction.
- Echocardiographic parameters and cardiovascular reflexes were similar between groups and unaffected by HC dose.
- Forearm blood flow increased significantly upon reducing HC dose from 30 mg to 15 mg/day.
Conclusions:
- This study did not confirm cardiovascular dysfunction in GH-deficient hypopituitary adults; lower BP may be protective.
- Reducing HC dose was well-tolerated but showed no significant clinical benefit over 3 months.
- Further prospective studies are needed to clarify cardiovascular outcomes in adult GH deficiency.