Exploring the cardiovascular impact of functioning pituitary tumours

Abstract

Objective: This study aimed to assess the cardiovascular burden in patients with functioning pituitary tumours. Methods: A retrospective analysis was conducted on 257 patients with functioning pituitary tumours (137 acromegaly, 94 Cushing's disease, 26 prolactinoma) who underwent surgery. Cardiovascular events, tumour characteristics, age at diagnosis, tumor activity status were evaluated. We also evaluated the relationship between the achievement of remission after surgery and the use of hormonal control therapy with cardiovascular events. Results: Cerebrovascular and cardiovascular disease occurred in 10.9%, 8.5%, and 3.8% of patients with acromegaly, Cushing's disease and prolactinoma, respectively. Significant differences were found in the prevalence of diabetes/pre-diabetes (p=0.008) and hypertension (p=0.045) among tumour types - higher in patients with acromegaly and Cushing's disease and lower in patients with prolactinomas. Dyslipidaemia was highly prevalent across all groups. In acromegaly, patients diagnosed after age 50 years had higher rates of diabetes, cerebrovascular and cardiovascular disease and hypertension. Cushing's disease patients diagnosed after 50 years had significantly higher rates of hypertension and dyslipidemia. Disease duration and tumour control status showed no correlation with cardiovascular outcomes. Patients with Cushing's disease who did not achieve remission postoperatively had more cardiovascular and cerebrovascular events (p=0.002). Conclusion: Patients with functioning pituitary tumours demonstrate a high cardiovascular burden even after tumour control. The impact varies among tumour types. These findings highlight the need for long-term cardiovascular monitoring and management in these patients, regardless of tumour control status. In patients with Cushing's disease, remission in the immediate postoperative period is associated with fewer cardiovascular and cerebrovascular events.