[The Influence of the growth hormone in the profile of blood pressure. Results in adult patients with deficiency in this hormone].
OBJECTIVE
There is an increasing interest in the relationship between the growth hormone (GH) and the heart since the GH has an important inotropic effect and its use has been tested in patients with severe systolic dysfunction. However, cardiovascular diseases are the main cause of increased morbimortality observed in patients with acromegaly. Growth hormone deficiency has been related to different clinical findings depending on the age of onset. Recent studies have demonstrated that GH deficiency in adults is associated with alterations in blood pressure. The aim of our study was to assess the influence of GH in blood pressure.


METHODS
We studied 14 adult patients with GH deficiency and 15 healthy subjects, matched for sex and age. The diagnosis of GH deficiency was based on GH response to intravenous insulin tolerance test < 5 ng/ml and IGF-1 levels lower than the normal limit for each age group. In all the patients 24-hour Holter blood pressure monitorization was performed in addition to a treadmill test and echographic evaluation.


RESULTS
All patients showed normal systolic and diastolic function in the echocardiographic study. Only one patient had an increased left ventricular mass. Blood pressure was lower in the patients than in the control subjects (p < 0.05). Moreover, the difference remained significant when analysis was based on the time of day. However, the patients showed normal blood pressure response to the effort test with a mean increase of 60%. The length of the exercise on the treadmill test was shorter in the subgroup of GH deficient patients.


CONCLUSIONS
Lower systolic blood pressure was observed in GH deficiency patients. The patients studied did not show structural heart alterations. Blood pressure and chronotrophic response to the effort test were similar in both groups.
Servicio de Cardiología, Sección de Endocrinología, Hospital General Universitario de Alicante. vcliment@coma.es
V
V
Climent Payá
F
F
Marín Ortuño
P
P
Valencia Valencia
A M
AM
Picó Alfonso
J
J
Gabriel Martínez Martínez
J
J
Antonio Quiles Llorens
F
F
García de Burgos
F
F
Sogorb Garri
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D013006:Growth Hormone / Q000172:deficiency* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
D013006:Growth Hormone