TOPLINE

A new Finnish nationwide cohort study found that patients with acromegaly had about 1.6-fold higher cardiovascular morbidity than matched control individuals from the general population. The risk was already evident years before diagnosis and persisted for decades, even in patients whose hormone levels were biochemically controlled.

METHODOLOGY

• Researchers conducted a nationwide, retrospective cohort study to compare cardiovascular morbidity in patients with acromegaly vs matched control individuals before diagnosis and during long-term follow-up and to identify factors associated with cardiovascular diseases, including treatment, biochemical control, and pituitary function.
• The analysis included 565 patients (median age, 49.2 years; 50.4% male individuals) diagnosed with acromegaly between 1980 and 2015 and 5629 matched control individuals. Most patients (89%) underwent pituitary surgery, 57% received pharmacotherapy, and 28% received radiotherapy.
• Cardiovascular events were tracked from 10 years before diagnosis through more than 30 years of follow-up; the median follow-up duration after diagnosis was 17.2 years.
• Cardiovascular diagnoses were grouped into eight categories: hypertension, cardiac arrhythmias, diseases of arteries and veins, coronary artery disease, cerebrovascular diseases, heart failure, valvular diseases and cardiomyopathies, and pulmonary arterial diseases.
• Statistical models examined independent risk factors for cardiovascular diseases among patients with acromegaly.

TAKEAWAY

• Patients with acromegaly faced roughly 1.6-fold higher risk for any cardiovascular disease than matched control individuals (P < .001), with the steepest increases seen in pulmonary arterial diseases, valvular diseases and cardiomyopathies, and hypertension (P < .001 for all).
• Cardiovascular morbidity, mostly venous conditions such as varicose veins and haemorrhoids, was already more common in patients with acromegaly years before diagnosis; after diagnosis, hypertension, diseases of arteries and veins, and arrhythmias were most frequent, and some conditions emerged only after 10-15 years of follow-up.
• Only hypertension and cardiac arrhythmias remained significantly more common among patients treated with surgery alone who achieved normal insulin-like growth factor 1 (IGF-1) levels and had no hypopituitarism than among matched control individuals.
• Among patients with acromegaly, radiotherapy, posttreatment IGF-1 levels above or below the reference range, and deficiency of multiple pituitary hormones were each associated with higher cardiovascular morbidity in specific disease groups.

IN PRACTICE

"[The study] results highlight the importance of long-term follow-up studies in demonstrating the entire cardiovascular burden on treated patients with acromegaly," the authors wrote. "The results call for earlier diagnostics of acromegaly and careful management of its cardiovascular comorbidities," they added.

SOURCE

The study was led by Antti Partanen, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. It was published online on September 18, 2026, in the European Journal of Endocrinology.

LIMITATIONS

The study was retrospective and observational, and cardiovascular disease was probably diagnosed and recorded more readily in patients than in control individuals. Hormone concentrations were not assessed over time, leaving uncertainty about the cumulative exposure to growth hormone and IGF-1. Smoking and a family history of early cardiovascular disease were poorly documented and not included in the analysis.

DISCLOSURES

This study was supported by grants from the state funding for university-level health research, Tampere University Hospital, Wellbeing Services Counties of Pirkanmaa and South Ostrobothnia, Tampere University Hospital Support Foundation, and other sources. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.