Adolescent acromegaly and decreased arterial distensibility despite successful treatment

OBJECTIVE: Cardiovascular complications that are probably related to the loss of arterial elasticity, such as secondary hypertension, occur frequently in patients with acromegaly and may persist after the condition has been treated. The aim of the study was to determine arterial compliance in adolescent patients with acromegaly who had undergone surgery to remove the adenoma in the pituitary gland. This is thought to be the first study on such patients. PATIENTS: Sixteen patients (nine male, seven female; mean age at diagnosis, 17·6 ± 1·3 years; mean age at time of study, 23·3 ± 3·7 years) who had undergone surgery for acromegaly that was caused by a pituitary adenoma. MEASUREMENTS: Arterial stiffness was measured by the standardized noninvasive QKd(100-60) method. In addition, blood pressure at rest was measured, ambulatory blood pressure was monitored over a 24-h period and transthoracic echocardiography was performed. RESULTS: Adolescent patients who had been operated upon for acromegaly showed disadvantageous differences in 24-h ambulatory blood pressure monitoring (systolic blood pressure, P < 0·001; diastolic blood pressure, P < 0·02; mean blood pressure, P < 0·01) and in QKd(100-60) value (194 ± 4 vs 205 ± 5 ms, P < 0·03) compared with controls. CONCLUSION: Despite successful treatment, the patients showed significantly decreased arterial distensibility as compared with controls, which might explain the observed differences in blood pressure. The findings show that such patients are at increased risk of developing cardiovascular diseases, despite their being youth and the restoration of normal secretion of growth hormone/insulin growth factor.