Background- Few reports in the literature deal with the blood pressure profile of adults with Growth Hormone Deficiency (GHD). In this case-control study we evaluated the effects of GHD on Blood Pressure (BP) by 24 hours Ambulatory Blood Pressure Monitoring (ABPM). Methods and Results- 31 consecutive patients (mean age 42.16±18.38 years, 20 men), with severe GHD (peak GH response to provocative testing <9 mU/l; mean disease duration: 31±13 months), not in GH replacement therapy, were recruited. A control group of 30 healthy subjects (mean age 40±15 years, 20 men) was considered for comparison. Exclusion criteria were: hypertension, previous cardiovascular disease, heart failure, ischemic heart disease, dyslipidemia, cigarette smoking, diabetes mellitus, other neoplasia, family history of heart disease, chronic obstructive pulmonary disease, renal failure, anemia.Physical examination, blood pressure measurement, ECG and 24-hour Ambulatory BP Monitoring were obtained. ABPM recordings were conducted using an A&D TM2430 device (measurements every 15 min from 06.00 to 23.00 and 30 min for the remaining period).GHD patients showed a mean 24-h Systolic BP (SBP) and Diastolic BP (DBP) of respectively 124.78±12.29 mmHg and 74.53±9.01 mmHg; mean daytime SBP: 128.18±12.86 mmHg; mean daytime DBP: 77.24±9.17 mmHg; mean night-time SBP: 111.14±11.58 mmHg; mean night-time DBP: 63.82±8.67 mmHg.Controls mean 24-h SBP and DBP were respectively 126.10±7.20 mmHg (p: 0.614 vs GHD) and 73.45±6.21 mmHg (p: 0.591 vs GHD); mean daytime SBP: 128.63±7.16 mmHg (p: 0.868 vs GHD); mean daytime DBP: 75.20±6.08 mmHg (p: 0.314 vs GHD); mean night time SBP: 114.72±9.15 mmHg (p: 0.189 vs GHD); mean night time DBP: 65.63±6.82 mmHg (p: 0.373 vs GHD).A BP nocturnal fall by 10 to 20% was detected in 35.5% GHD patients; 32.25% showed an ”extreme dipping” pattern (nocturnal fall >20%) and 32.25% a non dipping pattern (nocturnal fall <10%).In the control group a non dipping pattern was observed in 10% subjects. Conclusions- When comparing BP mean values, no significant differences were found between the two groups. By contrast, a remarkable prevalence of “unusual” BP profiles (involving prognostic implications) characterized by “non-dipping” and “extreme dipping” patterns was highlighted in adults with GHD (p<0.03 vs Controls)
24-hours blood pressure profile in adult GH deficiency / Moroni, Carlo; L., Valente; M. D., Tinti; F., Lopreiato; S. C., Ferracane; R., Iuorio; M., D’Armiento; Gaudio, Carlo; Gargiulo, Patrizia. - In: JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION. - ISSN 1720-8386. - 36:(2013), pp. 61---. (Intervento presentato al convegno XXXVI NATIONAL CONGRESS OF THE ITALIAN SOCIETY OF ENDOCRINOLOGY tenutosi a PADOVA (IT) nel 5-8 GIUGNO 2013).
24-hours blood pressure profile in adult GH deficiency
MORONI, Carlo;GAUDIO, Carlo;GARGIULO, Patrizia
2013
Abstract
Background- Few reports in the literature deal with the blood pressure profile of adults with Growth Hormone Deficiency (GHD). In this case-control study we evaluated the effects of GHD on Blood Pressure (BP) by 24 hours Ambulatory Blood Pressure Monitoring (ABPM). Methods and Results- 31 consecutive patients (mean age 42.16±18.38 years, 20 men), with severe GHD (peak GH response to provocative testing <9 mU/l; mean disease duration: 31±13 months), not in GH replacement therapy, were recruited. A control group of 30 healthy subjects (mean age 40±15 years, 20 men) was considered for comparison. Exclusion criteria were: hypertension, previous cardiovascular disease, heart failure, ischemic heart disease, dyslipidemia, cigarette smoking, diabetes mellitus, other neoplasia, family history of heart disease, chronic obstructive pulmonary disease, renal failure, anemia.Physical examination, blood pressure measurement, ECG and 24-hour Ambulatory BP Monitoring were obtained. ABPM recordings were conducted using an A&D TM2430 device (measurements every 15 min from 06.00 to 23.00 and 30 min for the remaining period).GHD patients showed a mean 24-h Systolic BP (SBP) and Diastolic BP (DBP) of respectively 124.78±12.29 mmHg and 74.53±9.01 mmHg; mean daytime SBP: 128.18±12.86 mmHg; mean daytime DBP: 77.24±9.17 mmHg; mean night-time SBP: 111.14±11.58 mmHg; mean night-time DBP: 63.82±8.67 mmHg.Controls mean 24-h SBP and DBP were respectively 126.10±7.20 mmHg (p: 0.614 vs GHD) and 73.45±6.21 mmHg (p: 0.591 vs GHD); mean daytime SBP: 128.63±7.16 mmHg (p: 0.868 vs GHD); mean daytime DBP: 75.20±6.08 mmHg (p: 0.314 vs GHD); mean night time SBP: 114.72±9.15 mmHg (p: 0.189 vs GHD); mean night time DBP: 65.63±6.82 mmHg (p: 0.373 vs GHD).A BP nocturnal fall by 10 to 20% was detected in 35.5% GHD patients; 32.25% showed an ”extreme dipping” pattern (nocturnal fall >20%) and 32.25% a non dipping pattern (nocturnal fall <10%).In the control group a non dipping pattern was observed in 10% subjects. Conclusions- When comparing BP mean values, no significant differences were found between the two groups. By contrast, a remarkable prevalence of “unusual” BP profiles (involving prognostic implications) characterized by “non-dipping” and “extreme dipping” patterns was highlighted in adults with GHD (p<0.03 vs Controls)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
