Growth hormone and cardiovascular risk markers.

The association of hypopituitarism and growth hormone (GH) deficiency with increased cardiovascular mortality has become increasingly well established. In GH-deficient adults, whether the onset of disease is in childhood or in adult life, a higher prevalence of atherosclerotic plaques and endothelial dysfunction has been described. Of note, high-resolution ultrasonography has shown that patients with hypopituitarism have a higher prevalence of premature atherosclerosis even in the absence of clinical symptoms. Specific anatomic abnormalities also have been described in adults with GH deficiency, including an increase in intimal-medial wall thickness. The contribution of specific hormonal factors and prior irradiation to the development of vascular disease remains controversial.