Cardiovascular risk in patients with hypopituitarism after surgery: comparison to matched data from the general population

Objective: Data on cardiovascular risk in patients with postsurgical pituitary failure are scarce. The aim of the study was to investigate whether patients with hypopituitarism show an increased coronary risk in comparison to the general population.

Patients and methods: Cardiovascular risk factors were assessed in 105 patients with pituitary hormone deficiency (53 men, 51 women, aged 58 ± 9yrs) at 12 months after pituitary surgery. Patients were on adrenal, thyroid and gonadal replacement therapy. Data were matched to 525 controls from the general population (Heinz Nixdorf Recall study). For estimation of the likelihood of a myocardial infarction the Framingham Risk Score (FRS) was calculated.

Results: The mean number of deficient pituitary axes was 2.3 ± 1.4. ACTH, TSH, gonadotropin and STH deficiency were present in 48%/62%/55% and 61% of patients, respectively. The number of subjects with diabetes mellitus and left ventricular hypertrophy (LVH) was significantly higher in pituitary patients compared to the control group (p = 0.008) and (p = 0.01)). 21.0% of pituitary patients and 22.9% of controls were smokers. Total and LDL cholesterol were significantly lower in pituitary patients compared to controls (p = 0.004) while triglyceride levels were significantly higher (p = 0.004)). There was no difference in the calculated FRS in pituitary patients compared to age- and gender-matched controls (p = 0.71). Furthermore the number of deficient pituitary axes did not correlate with the FRS (p = 0.71) and the FRS was not higher in patients with or without STH deficiency (p = 0.17)).

Conclusion: Twelve months after pituitary surgery we found an increased prevalence of diabetes mellitus and LVH in hypopituitary patients under hormone replacement therapy, however the calculated FRS was not higher than in the general population.