title: Growth hormone deficiency and vascular risk.
abstract: The importance of growth hormone deficiency (GHD) in adult life has become more apparent over the last decade. As well as a distinct clinical syndrome there is a significant excess risk of cardiovascular disease. Although it is difficult to ascertain what part is played by the original pituitary disorder and the concomitant replacement hormonal therapies, there is clear evidence that GHD is associated with known cardiovascular risk factors such as body shape, lipid profile, insulin resistance, blood pressure, vessel wall morphology and haemostatic factors. Novel means of assessing vascular risk such as pulse wave velocity and flow-mediated dilatation can also estimate the risk without invasive procedures. The role of possible mediators of endothelial function such as nitric oxide and free radicals is being investigated further. Replacement of GH in GH-deficient patients leads to many effects on the above indices, some but not all of which are associated with reduced vascular risk. Long-term follow-up studies of morbidity and mortality are required for an accurate assessment of the beneficial effects of therapy.
authors.affiliation: Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK. roland.mccallum@ntlworld.com
authors.forename: Roland W
authors.initials: RW
authors.lastname: McCallum
authors.forename: John R
authors.initials: JR
authors.lastname: Petrie
authors.forename: Anna F
authors.initials: AF
authors.lastname: Dominiczak
authors.forename: John M C
authors.initials: JM
authors.lastname: Connell
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000503:physiopathology; D006487:Hemostasis; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications; D010900:Pituitary Diseases / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D013004:Somatostatin / Q000172:deficiency*; D006113:United Kingdom; D014655:Vascular Resistance
chemical_list: D019382:Human Growth Hormone; D013004:Somatostatin