Endocrine Abstracts

Purpose: Hypertension is an independent factor of cardiovascular morbidity in acromegaly patients. Obstructive sleep disordered breathing (SDB) is the most common respiratory impairment in acromegaly and is considered one of the mechanisms underlying the development of hypertension in this disorder.

Aim: To study blood pressure parameters and prevalence of hypertension in naïve acromegaly patients depending on the presence of moderate-to-severe obstructive sleep apnea.

Materials and methods: Forty-eight naïve acromegalic patients (11 men, 37 women, median age 53.5 (27–76) years) were recruited into the study. All subjects underwent clinical examination including office blood pressure measurement, full polysomnography, twenty-four blood pressure monitoring (24-hour BPM).

Results: SDB, namely obstructive sleep apnea, was found in 36 (75%) patients. Thirteen patients (36%) had mild, eleven (31%) - moderate and twelve (33%) showed severe OSA. The latter two groups (moderate-to-severe OSA, further referred as patients with OSA) were compared to patients without OSA (non-OSA). In patients with OSA office diastolic blood pressure was significantly higher than in patients without OSA (P<0.03). According to 24-hour BPM mean 24-hour, daytime and nighttime blood pressure were significantly higher in patients with OSA as compare to non-OSA subjects. The rate of office hypertension (χ²=3.85; P<0.05), mean 24-hour (χ²=4.8; P=0.03) and nighttime hypertension (χ²=5.23; P<0.03) was significantly higher in OSA group, while the frequency of daytime hypertension was similar in both groups.

Conclusion: According to the office measurement and 24-hour BPM the blood pressure parameters and prevalence of hypertension were higher in patients with OSA. According to our data, patients with newly diagnosed acromegaly should be recommended to undergo polysomnography study in order to detect ones at higher risk of hypertension development.