ABNORMAL CAROTID ARTERIAL-WALL DYNAMICS IN SYMPTOM-FREE HYPOPITUITARYADULTS

Objective: Although vascular mortality is increased in hypopituitary a dults on routine replacement, there are limited data on the atheroscle rotic process during life in these patients, Measurement of arterial s tiffness may provide an index of early vascular changes that predispos e to the development of major vascular accidents, Design: Thirty-four hypopituitary adults on conventional replacement therapy and 39 age- a nd sex-matched controls were studied. They had no history or clinical evidence of macrovascular disease, The common carotid artery distensib ility coefficient (DC), compliance coefficient (CC) and arterial stiff ness index (beta index) were calculated from high-resolution ultrasoni c imaging of the two common carotid arteries and from the brachial blo od pressure. Results: There was no difference between patients and con trols in carotid diastolic diameter (mean+/-S.E.M.) (5.55+/-0.16 vs 5. 45+/-0.08 mm) and pulse pressure (6.66+/-0.30 vs 6.58+/-0.24 kPa). The increase in diameter during systole was significantly lower in the hy popituitary patients (0.39+/-0.02 vs 0.50+/-0.03 mm, P<0.001), The DC was significantly lower in patients than in controls (24.2+/-2.29 vs 3 0.1+/-2.01 10(-3) kPa(-1), P<0.05), The carotid CC was also significan tly lower in patients than in controls (57+/-0.49 vs 7.0+/-0.45 10(-7) m(2)kPa(-1), P<0.05). The beta index was higher in the patient group (8.4+/-1.3 vs 5.9+/-0.37, P<0.05). When men and women were considered separately, the differences between patients and controls were statist ically significant in women but not in men and were more marked in the older women subgroup. Conclusion: Asymptomatic hypopituitary adults ( especially women) on conventional replacement therapy have increased s tiffness of the common carotid arteries. These findings provide additi onal evidence for a process leading to premature atherosclerosis in th is group of patients.