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Importance of 24 h ambulatory blood pressure monitoring in patients with acromegaly and correlation with cardiac magnetic resonance findings

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Abstract

Introduction

Arterial hypertension (AH) is prevalent in acromegaly, but few studies using 24-h ambulatory blood pressure monitoring (24 h-ABPM) suggest that its frequency may be different from office blood pressure (OBP). Left ventricular hypertrophy (LVH) is one of the most frequent cardiac abnormalities. Cardiac magnetic resonance (CMR) is considered the gold standard to evaluate the heart.

Objectives

To compare the frequency of AH when measured by 24 h-ABPM and by OBP and to correlate BP with cardiac mass.

Methods

Patients over 18 years of age with acromegaly underwent OBP evaluation and were later referred to the 24 h-ABPM. Treatment-naïve patients were submitted to CMR.

Results

We evaluated 96 patients. From 29 non hypertensive patients by OBP, 9 had AH on 24 h-ABPM. In the group of patients with a previous diagnosis of AH by OBP, 25 had controlled BP and 42 had abnormal BP on 24 h-ABPM, when analyzed by OBP there were 28 with controlled BP. We observed a positive correlation between diastolic BP measured in 24 h-ABPM and IGF-I levels, but we did not observe the same correlation with age, sex, body mass index and GH levels. The CMR was performed in 11 patients. We found a positive correlation of left ventricular mass (LVM) and BP of 24 h-ABPM. In contrast, there was no correlation of OBP with CMR parameters.

Conclusions

We observed, that 24 h-ABPM in acromegaly allows the diagnosis of AH in some patients with normal BP in OBP and also to allow a better treatment. 24 h-ABPM shows a better correlation with VM by CMR.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Author information

Authors and Affiliations

  1. Endocrine Unit and Neuroendocrinology Research Center, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Paula Rocha, Monica Gadelha & Leandro Kasuki

  2. Rede Do’r São Luiz, Rio de Janeiro, Brazil

    Julia Barroso

  3. Resistant Hypertension Program (ProHArt-HUCFF), Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Fernanda Carlos & Elizabeth Muxfeldt

  4. Medical School - Rio de Janeiro, Universidade Estácio de Sá, Campus Centro I - Presidente Vargas, Rio de Janeiro, RJ, Brazil

    Elizabeth Muxfeldt

  5. Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil

    Monica Gadelha & Leandro Kasuki

  6. Neuropathology and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil

    Monica Gadelha

  7. Endocrine Unit and Neuroendocrinology Research Center, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 9° Andar, Setor 9F, Sala de Pesquisa em Neuroendocrinologia, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil

    Leandro Kasuki

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Contributions

PR collected the data and wrote the initial draft, FC and JB performed the cardio logic evaluations supervised by EM, MG and LK supervised the study and critically reviewed the data. All others approved the final version of the manuscript.

Corresponding author

Correspondence to Leandro Kasuki.

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Conflict of interest

M.R.G. has served as an advisory board member for Ipsen, Novartis Pharmaceuticals, Novo Nordisk, Re-cordati Rare Diseases and Crinetics Pharmaceuticals; as a research investigator for Crinetics Pharmaceuticals, Recordati Rare Diseases and Novartis Pharmaceuticals; and as a speaker for Crinetics Pharmaceuticals, Novartis Pharmaceuticals, Ipsen, Novo Nordisk and Recordati Rare Diseases. L.K. has received speaker fees from Novartis and Ipsen.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of HUCFF/UFRJ (3. 858. 071) and Faculdade de Medicina da UFRJ and all patients signed written informed consent forms.

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Rocha, P., Barroso, J., Carlos, F. et al. Importance of 24 h ambulatory blood pressure monitoring in patients with acromegaly and correlation with cardiac magnetic resonance findings. Pituitary 26, 402–410 (2023). https://doi.org/10.1007/s11102-023-01321-8

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