Importance of 24 Hours Ambulatory Blood Pressure Monitoring in Patients With Acromegaly and Correlation With Cardiac Magnetic Resonance Findings

Abstract

Abstract Arterial hypertension (AH) is prevalent in acromegaly, but few studies using 24-hour ambulatory blood pressure monitoring (24h-ABPM) suggest that its frequency may be different from office blood pressure (OBP). Left ventricular hypertrophy (LVH) is one of the most frequent cardiac abnormalities. Cardiac magnetic resonance (CMR) is considered the gold standard to evaluate the heart. OBJECTIVES: To compare the frequency of AH when measured by 24h-ABPM and by OBP and to correlate BP with cardiac mass. METHODS: Patients over 18 years of age with acromegaly underwent OBP evaluation and were later referred to the 24h-ABPM. Treatment-naïve patients were submitted to CMR. RESULTS: We evaluated 96 patients. From 29 non hypertensive patients by OBP, 9 had AH on 24h-ABPM. In the group of patients with a previous diagnosis of AH by OBP, 25 had controlled BP and 42 had abnormal BP on 24h-ABPM when analyzed by OBP there were 28 with controlled BP. We observed a positive correlation between diastolic BP measured in 24h-ABPM and IGF-I levels, but we do not observe the same correlation with age, sex, body mass index and GH levels. The CMR was performed in 11 patients. We found a positive correlation of left ventricular mass (LVM) and BP of 24h-ABPM. In contrast, there was no correlation of OBP with CMR parameters. CONCLUSIONS: We observed, that 24h-ABPM in acromegaly allows the diagnosis of AH in some patients with normal BP in OBP and also to allow a better treatment. 24h-ABPM shows a better correlation with VM by CMR. We observed that 24h-ABPM in acromegaly is important because it allows the diagnosis of arterial hypertension in some patients with normal blood pressure in OBP and also to allow a better management of drug treatment in patients previously diagnosed with AH. Also, it shows a better correlation with ventricular mass when assessed by the gold-standard method CMR. Therefore, we think our study can contribute to the management of patients with acromegaly, highlighting the importance of using 24h-ABPM and not only OBP in these patients.