Abnormal vascular reactivity in growth hormone deficiency

Circulation. 2001 Jan 30;103(4):520-4. doi: 10.1161/01.cir.103.4.520.


Background: The reason why patients with growth hormone (GH) deficiency (GHD) are at increased risk for premature cardiovascular death is still unclear. Although a variety of vascular risk factors have been identified in GHD, little is known regarding vascular reactivity and its contribution to premature arteriosclerosis.

Methods and results: We assessed vascular function in 7 childhood-onset, GH-deficient nontreated patients (age 22+/-3 years, body mass index [BMI] 25+/-1 kg/m(2)) and 10 healthy subjects (age 24+/-0.4 years, BMI 22+/-1 kg/m(2)) by using strain gauge plethysmography to measure forearm blood flow in response to vasodilatory agents. The increase in forearm blood flow to intrabrachial infusion of the endothelium-dependent vasodilator acetylcholine was significantly lower in GH-deficient nontreated patients than in control subjects (P:<0.05). Likewise, forearm release of nitrite and cGMP during acetylcholine stimulation was reduced in GH-deficient nontreated patients (P:<0.05 and P:<0.002 versus controls). The response to the endothelium-independent vasodilator sodium nitroprusside was also markedly blunted in GH-deficient patients compared with control subjects (P:<0.005). To confirm that abnormal vascular reactivity was due to GHD, we also studied 8 patients with childhood-onset GHD (age 31+/-2 years, BMI 24+/-1 kg/m(2)) who were receiving stable GH replacement therapy. In these patients, the response to both endothelium-dependent and -independent vasodilators, as well as forearm nitrite and cGMP, release was not different from that observed in normal subjects. Peak hyperemic response to 5-minute forearm ischemia was significantly reduced in GH-deficient nontreated patients (17.2+/-2.6 mL x dL(-1) x min(-1), P:<0.01) but not in GH-treated patients (24.8+/-3.3 mL x dL(-1) x min(-1)) compared with normal subjects (29.5+/-3.2 mL x dL(-1) x min(-1)).

Conclusions: The data support the concept that GH plays an important role in the maintenance of a normal vascular function in humans.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acetylcholine / pharmacology
  • Adult
  • Blood Flow Velocity / drug effects
  • Blood Pressure / drug effects
  • Blood Vessels / drug effects
  • Blood Vessels / physiopathology*
  • Cyclic GMP / blood
  • Dose-Response Relationship, Drug
  • Female
  • Forearm / blood supply
  • Growth Hormone / deficiency*
  • Growth Hormone / therapeutic use
  • Hormone Replacement Therapy
  • Humans
  • Ischemia / physiopathology
  • Male
  • Nitrites / blood
  • Nitroprusside / pharmacology
  • Vasodilator Agents / pharmacology


  • Nitrites
  • Vasodilator Agents
  • Nitroprusside
  • Growth Hormone
  • Cyclic GMP
  • Acetylcholine