Endocrine Abstracts

Introduction: Patients with Sheehan’s syndrome (SS) may experience alterations in blood pressure (BP) regulation, possibly due to hormones deficiencies and hormone replacement treatment. The aim of the present study was to assess the 24h ambulatory BP in women with Sheehan syndrome.

Methods: This was a monocentric cross-sectional study involving 50 women with complete anterior hypopituitarism secondary to SS and 50 age and body-mass index (BMI) matched control women. All participants underwent clinical examination, laboratory tests, and BP measurement using ambulatory 24h-monitoring.

Results: The mean age was 62.2 ± 9.4 years in patients vs 60.6 ± 8.4 years in controls (P=0.385). The prevalence of hypertension before the study was 30% in patients with SS and 6% in controls (P=0.002). Newly diagnosed hypertension was established in 48% of patients and 58% of controls. The overall prevalence of hypertension was 78% in patients and 64% in controls (P= 0.123). Altered nycthemeral variations in BP was observed in patients, who had more frequent non-dipper or riser profile than controls (P<0.001). Additionally, they had significantly higher frequency of nocturnal hypertension (38% vs 3%; P=0.002). SS was positively associated with a non-dipper/riser BP profile (Odds Ratio (OR) =4.09; 95%-confidence interval (CI): 1.58-10.55, P=0.003). Factors associated with hypertension in patients included age >50 years (OR=14.25, 95%-CI: 1.30-155.22, P=0.029), duration of SS > 20 years (OR=6.8, 95%-CI: 0.96-47.3; P=0.034), BMI ≥ 26 kg/m² (OR=12.19, 95%-CI: 2.56-57.93, P<0.001), waist circumference ≥ 100 cm (OR=6.78, 95%-CI: 1.51-30.39, P=0.007), waist circumference/height ratio ≥ 0.62 (OR=14.66, 95%-CI:3.00-71.67, P<0.001), and visceral fatty area ≥ 150 cm² (OR=6, 95%-CI: 1.20-30.01, P=0.022). Hypertensive patients had a significantly higher cumulative dose of hydrocortisone compared to non-hypertensive patients (439.1±227 vs 315.9±193, P=0.006). Thirteen percent of hypertensive patients were on a daily hydrocortisone dose >20 mg, while all non-hypertensive patients were on 15 to 20 mg/day.

Conclusion: Our results showed a high prevalence of hypertension in women with SS and a higher disruption of the circadian BP rhythm in patients than in controls. Age, disease duration, BMI, visceral adiposity, and cumulative hydrocortisone dose were associated with hypertension.