Ambulatory monitoring of blood pressure in growth hormone-deficient adults.

The aim of this study was to evaluate the 24-h pattern of blood pressure in adults with growth hormone deficiency using ambulatory blood pressure monitoring. We therefore evaluated the mean systolic and diastolic blood pressures, systolic and diastolic blood pressure loads and diurnal blood pressure rhythm. We used an auscultatory-type monitor, the measurements being made at 10-15 min intervals during the day and 20-30 min intervals at night. We included patients with a growth hormone peak of less than 3 ng/ml in at least two stimulation tests: the insulin tolerance and glucagon tests. The exclusion criteria were mental illnesses, pregnancy, diabetes mellitus, blood pressure higher than 160/90 mmHg, the use of growth hormone in the previous 12 months, severe acute illnesses, chronic liver or kidney disease and a history of malignancy. The results were interpreted according to the II Brazilian Consensus for the utilization of ambulatory monitoring. The study population comprised 27 adult patients with growth hormone deficiency, 11 male and 16 female, with an age range of 21-62 years. Five had developed the condition during childhood, whereas the remainder had adult-onset growth hormone deficiency. The mean systolic (115 +/- 16.7 mmHg) and diastolic blood pressure loads (75.51 +/- 1.90 mmHg) were normal. There was a tendency towards a lower blood pressure in patients with childhood-onset growth hormone deficiency when compared with their adult-onset counterparts. Men had a lower systolic blood pressure than women, the same pattern being found for mean diastolic blood pressure. Multiple regression analysis showed that age was the only independent variable with the statistical power to explain the variance of blood pressure in this group of patients. The incidence of non-dippers was 37.03%. Growth hormone deficiency thus seems to be associated with a change in the 24-h blood pressure pattern, with a high incidence of non-dippers.