Growth Hormone Predicts Cardiovascular Morbidity and Mortality

[Michael Scally MD]

Hallengren E, Almgren P, Engstrom G, et al. Fasting levels of high-sensitivity growth hormone predict cardiovascular morbidity and mortality: the Malmo Diet and Cancer study. J Am Coll Cardiol 2014;64(14):1452-60. https://www.sciencedirect.com/science/article/pii/S0735109714057180

BACKGROUND: Both pathological excess and deficiency of growth hormone (GH) are associated with cardiovascular mortality.

OBJECTIVES: The goal of this study was to test whether fasting levels of growth hormone measured with a high-sensitivity assay (hs-GH) predict cardiovascular morbidity and mortality at the population level.

METHODS: We studied 4,323 participants (age 46 to 68 years; mean age 58 years; 59% women) of the Swedish, population-based Malmo Diet and Cancer study examined in 1991 to 1994. Using multivariate-adjusted Cox proportional hazards models, we related baseline levels of fasting hs-GH to incidence of coronary artery disease, stroke, congestive heart failure, all-cause mortality, and cardiovascular mortality.

RESULTS: During a median follow-up of 16.2 years, hs-GH (hazard ratio

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/SD increment of natural logarithm of fasting hs-GH) was independently associated with
· increased risk of coronary artery disease (397 events; HR: 1.11; 95% confidence interval [CI]: 1.01 to 1.23; p = 0.04),
· stroke (251 events; HR: 1.18; 95% CI: 1.04 to 1.34; p = 0.01),
· congestive heart failure (107 events; HR: 1.25; 95% CI: 1.03 to 1.52; p = 0.02),
· all-cause mortality (645 events; HR: 1.17; 95% CI: 1.08 to 1.26; p < 0.001) and
· cardiovascular mortality (186 events; HR: 1.43; 95% CI: 1.24 to 1.66; p < 0.001).

The addition of hs-GH to a model with conventional cardiovascular risk factors significantly reclassified risk, with a category-free net reclassification improvement (>0) of 0.542 (95% CI: 0.205 to 0.840) in cardiovascular mortality.

CONCLUSIONS: Higher values of hs-GH were associated with an increased risk of cardiovascular morbidity and mortality.

 

[Dr JIM]

Really is this any surprise when it's well known many patients with Giantism don't celebrate their 50th birthday even with treatment. Perhaps for many the damage is already done once the diagnosis is made.

I do believe this study should create pause for those whom are using GH as an anabolic agent ESPECIALLY at high doses!

 

[tubesox]

so how big can the heart actually get?

 

[Dr JIM]

Define "big", I mean what are you referencing in the citation I presume?

 

[tubesox]

maybe 2x its original size? they say its the size of your fist naturally, right?

 

[Dr JIM]

From the UT Austin coroners office
"NORMAL HEARTS" AVERAGE 300GMS (+ - 50gms)
PATIENTS WITH "DILATED CARDIOMYOPATHY" easily DOUBLE the weight of normal hearts.

Thus the dimensions increase as does the weight. Ive seen patients CXR's where the heart consumes the entire left side of the thorax, with the normal being somewhere closer to 20-30%!.

 

[tubesox]

that's insane

 

[Dr JIM]

"NORMAL" CXR





That's all heart in both pics!

 

[tubesox]

Assuming patient is deceased?!

 

[kawilt]

I guess these studies were done with people that had naturally occurring HGH that was abnormally high throughout their lives and not exogenous? Seems like an awfully long sentence.

 

[Dr JIM]

Assuming patient is deceased?!

Nope but you may rightly assume they aren't working out in the gym next to you, lol!

Fact is many can't walk more than FIVE FEET wo becoming SOB, even with supplemental oxygen.

 

[Dr JIM]

I guess these studies were done with people that had naturally occurring HGH that was abnormally high throughout their lives and not exogenous? Seems like an awfully long sentence.

Every heard of the Wrestler Andre the Giant? He had Giantism and died in his mid 40's

 

[kawilt]

Yes, I know. I suppose there just haven't been any studies done on long term effects of exogenous HGH use. That's why all the conflicting opinions.
Right?

 

[Voltrader]

How about when you start Gh in the mid 40's at a anti aging dose. How many years it took Andre 40 something years before it took its toll. So I should be good til at least 70 right?

 

[tubesox]

damn volt, you tappin out at 70?

 

[Voltrader]

damn volt, you tappin out at 70?

How I ran in my teens and 20's figured 70 is more than I expected. My kids should be married by then and having kids. I am good with that.

 

[CensoredBoardsSuck]

I do believe this study should create pause for those whom are using GH as an anabolic agent ESPECIALLY at high doses!

Not only that but it suggests caution is warranted when using GH replacement therapy as antiaging therapy in healthy patients.

"Interestingly, at the population level, we found that patients with low hs-GH levels resembled GHD patients in having an unfavorable body composition and lipoprotein profile (Online Table 9). However, the relationship between hs-GH and cardiovascular morbidity and mortality was the opposite of that expected from the observations in GHD patients: subjects with low hs-GH had low risk, whereas subjects with high hs-GH had high risk."

"Today, GH use is not limited to individuals with GHD. For example, GH has been used as an antiaging therapy, and athletes also use it. A systematic review concluded that GH could not be recommended as antiaging therapy, and our results further highlight the impropriety and possible dangers of this practice (30)."

 

[Voltrader]

CBS you always got something to say. I don't understand in the healthy human category High LDL, Low HDL, High BMI is a healthy human? I don't think I am following the flow of the chart right.

Not only that but it suggests caution is warranted when using GH replacement therapy as antiaging therapy in healthy patients.

"Interestingly, at the population level, we found that patients with low hs-GH levels resembled GHD patients in having an unfavorable body composition and lipoprotein profile (Online Table 9). However, the relationship between hs-GH and cardiovascular morbidity and mortality was the opposite of that expected from the observations in GHD patients: subjects with low hs-GH had low risk, whereas subjects with high hs-GH had high risk."

"Today, GH use is not limited to individuals with GHD. For example, GH has been used as an antiaging therapy, and athletes also use it. A systematic review concluded that GH could not be recommended as antiaging therapy, and our results further highlight the impropriety and possible dangers of this practice (30)."

 

[Voltrader]

I got a question @Dr JIM or @Michael Scally MD Are there test I can have my doctor run every six months or a year to see if these increases are happening?

 

[Dr JIM]

I got a question @Dr JIM or @Michael Scally MD Are there test I can have my doctor run every six months or a year to see if these increases are happening?

What increases are you referring to VR? The adverse effects on CV mortality?