Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Does growth hormone replacement therapy improve cardiac function?

Nature Clinical Practice Endocrinology & Metabolism volume 3, pages 614–615 (2007)Cite this article

Growth hormone (GH) is a pituitary hormone under hypothalamic control, which exerts its actions at the multiple organ level either directly or indirectly via synthesis of insulin-like growth factor I.1 Cardiomyocytes express receptors for both GH and insulin-like growth factor I, and ligand binding directly affects contractility, calcium uptake and sensitivity, and apoptosis in isolated heart and cardiomyocytes. Moreover, GH and insulin-like growth factor I cause cardiac hypertrophy and enhance cardiac performance without a concomitant increase in energy expenditure.2,3

Epidemiologic studies in hypopituitary patients with untreated GH deficiency (GHD) have demonstrated that these patients have a reduced life expectancy from cardiovascular disease (ischemic heart disease and heart failure).4 The positive effects of GH on the heart have, therefore, been used to advocate GH-replacement therapy in adults with GHD since this treatment is not universally accepted (because of controversy about the supposed clinical benefits and potential adverse effects). In addition, the cost-effectiveness of GH therapy in adults with GHD is closely monitored by health-care regulators. In this article, I review the clinical evidence about the heart in untreated GHD, summarize the effects of GH therapy on cardiac structure and function, and discuss the relevance of these effects to the objectives of GHD management.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Giustina A and Veldhuis JD (1998) Pathophysiology of the neuroregulation of growth hormone secretion in experimental animals and the human. Endocr Rev 19: 717–797

    CAS  PubMed  Google Scholar 

  2. Gola M et al. (2005) Clinical review: Growth hormone and cardiovascular risk factors. J Clin Endocrinol Metab 90: 1864–1870

    Article  CAS  Google Scholar 

  3. Colao A et al. (2006) Beginning to end: cardiovascular implications of growth hormone (GH) deficiency and GH therapy. Growth Horm IGF Res 16 (Suppl A): S41–S48

    Article  CAS  Google Scholar 

  4. Rosen T and Bengsston BA (1990) Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 336: 285–288

    Article  CAS  Google Scholar 

  5. Colao A et al. (2002) The cardiovascular risk of adult GH deficiency (GHD) improved after GH replacement and worsened in untreated GHD: a 12-month prospective study. J Clin Endocrinol Metab 87: 1088–1093

    Article  CAS  Google Scholar 

  6. Shahi M et al. (1992) Myocardial dysfunction in treated adult hypopituitarism: a possible explanation for increased cardiovascular mortality. Br Heart J 67: 92–96

    Article  CAS  Google Scholar 

  7. Cuneo RC et al. (1989) Cardiac failure responding to growth hormone. Lancet 1: 838–839

    Article  CAS  Google Scholar 

  8. Volterrani M et al. (1997) Haemodynamic effects of intravenous growth hormone in congestive heart failure. Lancet 349: 1067–1068

    Article  CAS  Google Scholar 

  9. Gibney J et al. (1999) The effect of 10 years of recombinant human growth hormone (GH) in adult GH-deficient patients. J Clin Endocrinol Metab 84: 2596–2602

    Article  CAS  Google Scholar 

  10. Maison P and Chanson P (2003) Cardiac effects of growth hormone in adults with growth hormone deficiency: a meta-analysis. Circulation 108: 2648–2652

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Endocrine Section, 2a Medicina–Spedali Civili, 25125 Brescia, Italy a.giustina@libero.it

Authors and Affiliations

  1. A Giustina is an Associate Professor of Internal Medicine at the University of Brescia, Italy.,

    Andrea Giustina

Authors
  1. Andrea Giustina
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

Dr Giustina has received lecture fees from Eli Lilly Italia and is a member of the Advisory Board of Eli Lilly Italia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giustina, A. Does growth hormone replacement therapy improve cardiac function?. Nat Rev Endocrinol 3, 614–615 (2007). https://doi.org/10.1038/ncpendmet0588

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpendmet0588

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing