Document Detail


Altered circadian blood pressure profile in patients with active acromegaly. Relationship with left ventricular mass and hormonal values.
MedLine Citation:
PMID:  11550105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the relationships between the circadian blood pressure profile and left ventricular mass, hormonal pattern and insulin sensitivity indices in patients with active acromegaly, ambulatory 24-h blood pressure monitoring (ABPM) was recorded in 25 subjects (47.0 +/- 15.1 years, range 23-72). Serum growth hormone (GH) and insulin-like growth factor-1, fasting and mean plasma glucose and insulin during oral glucose tolerance test (OGTT), insulinogenic index, the sum of the plasma insulin levels and the homeostasis model insulin resistance index (Homa's index) were determined. Left ventricular mass index (LVMI) was calculated from two-dimensional guided M-mode echocardiogram. The prevalence of hypertension was 56% (n = 14) and 40% (n = 10) according to sphygmomanometric measurements and ABPM, respectively. Non-dipping profile was observed in six of 10 hypertensives and in six of 15 normotensives. Serum growth hormone, fasting glucose, the area under the serum insulin curve and LVMI were higher for acromegalics with non-dipping profile than for dippers (all of them, P < 0.05). In non-dippers daytime heart rate was higher than night time (P < 0.001). In conclusion, the main observations in the present study suggested that both normotensive and hypertensive acromegalics had a highly prevalent non-dipping profile with a preserved circadian pattern of heart rate, that was associated with higher levels of serum GH. The disturbance in nocturnal blood fall in normotensives was associated with a decreased insulin sensitivity. The role of GH in blood pressure circadian rhythm regulation in essential hypertension deserves further studies.
Authors:
D J Pietrobelli; M Akopian; A O Olivieri; A Renauld; D Garrido; R Artese; C A Feldstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  15     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-10     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  601-5     Citation Subset:  IM    
Affiliation:
Hypertension Program, Hospital de Clinicas San Martin Buenos Aires Schools of Medicine and Biochemistry, Buenos Aires, Argentina.
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / blood,  physiopathology*,  ultrasonography
Adult
Aged
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology*
Fasting / metabolism
Female
Glucose Tolerance Test
Growth Hormone / blood
Hormones / blood*
Humans
Hypertension / blood,  physiopathology*,  ultrasonography
Hypertrophy, Left Ventricular / blood,  physiopathology*,  ultrasonography
Insulin / blood
Insulin-Like Growth Factor I / analysis
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Hormones; 11061-68-0/Insulin; 67763-96-6/Insulin-Like Growth Factor I; 9002-72-6/Growth Hormone

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