Acromegaly and cardiovascular disease: mechanisms, clinical impact, and evolving management.

Cardiovascular disease is one of the most common and serious complications of acromegaly and a leading contributor to reduced life expectancy in affected individuals. This review examines the prevalence, mechanisms, diagnosis, and management of cardiovascular complications in patients with acromegaly. Growth hormone and insulin-like growth factor 1 excess promotes a range of cardiovascular disturbances, including structural heart changes, arrhythmias, vascular dysfunction, and an increased burden of traditional cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia. Early recognition and targeted treatment of these complications are critical to reducing cardiovascular morbidity and mortality. While surgery and medical therapies for acromegaly aimed at normalizing hormone levels may lead to partial or full reversal of some cardiovascular alterations, many patients require continued management of comorbid conditions to control their overall cardiometabolic risk. Advances in diagnostic strategies and therapeutic options have contributed to improved survival, yet gaps remain in our understanding of how best to prevent or reverse cardiovascular damage in this population. Multidisciplinary care and individualized risk assessment are essential components of modern acromegaly management.