title: Cardiovascular Disease and Sleep-Disordered Breathing in Acromegaly.
abstract: Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, hypertension, valvular heart disease and arrhythmias, while metabolic disturbance (insulin resistance/diabetes mellitus, dyslipidaemia) further increases the risk of cardiovascular and cerebrovascular events. Sleep-disordered breathing (in the form of sleep apnoea) is also common in patients with acromegaly and may exacerbate cardiovascular dysfunction, in addition to contributing to impaired quality of life. Accordingly, and in keeping with evidence that cardiorespiratory complications in acromegaly are not automatically reversed/ameliorated simply through the attainment of 'safe' growth hormone and insulin-like growth factor 1 levels, recent guidelines have emphasised the need not only to achieve stringent biochemical control, but also to identify and independently treat these comorbidities. It is important, therefore, that patients with acromegaly are systematically screened at diagnosis, and periodically thereafter, for the common cardiovascular and respiratory manifestations and that biochemical targets do not become the only treatment goal.
authors.affiliation: Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Powlson
authors.forename: Mark
authors.initials: M
authors.lastname: Gurnell
mesh_terms: D000172:Acromegaly; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D012119:Respiration; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000188:drug therapy*
chemical_list: D019382:Human Growth Hormone