Acromegaly: the silent disease that causes complications such as hypertension, diabetes, and heart failure

In Colombia, acromegaly—a rare but clinically significant hormonal disease—remains a silent challenge for the healthcare system. Despite a prevalence of approximately 60 cases per million inhabitants and 3.5 new diagnoses reported annually per million, specialists warn that a significant number of people remain undiagnosed, delaying treatment and exacerbating complications.

According to the Colombian consensus on diagnostic and therapeutic criteria for acromegaly, developed by the Colombian Association of Endocrinology, Diabetes and Metabolism (ACE), most cases are detected between the ages of 40 and 60, with a slight predominance in men. However, underdiagnosis remains a constant problem: it is estimated that the process to reach an accurate diagnosis can take between five and ten years, a critical period that allows irreversible damage to progress in the body.

“Diagnosis often takes several years, and during that time patients develop cardiovascular, bone, metabolic, and hormonal complications that deteriorate their quality of life and increase their risk of mortality,” explains Dr. Henry Tovar, an endocrinologist and member of the ACE (Spanish Association of Endocrinologists). The specialist warns that early detection can make the difference between a life with limitations and a life with the disease under control, which is why he insists on the need to strengthen medical training and promote the recognition of clinical signs in primary care.

Although acromegaly is often associated only with visible physical changes—such as the progressive growth of hands, feet, or facial features—its effects extend far beyond outward appearance. Specialists remind us that it is a multisystemic disease resulting from an overproduction of growth hormone, which can affect various organs and systems.

Among the most common complications are high blood pressure, type 2 diabetes, sleep apnea, heart failure, osteoporosis, sex hormone imbalances, and an increased risk of colorectal cancer. These manifestations make acromegaly a public health problem that requires interdisciplinary care, continuous monitoring, and timely access to specialized tests.

In observance of World Acromegaly Day, commemorated on November 1st, the Spanish Association of Acromegaly Patients (ACE) has reinforced its commitment to raising awareness and providing comprehensive care for this condition. To this end, it is promoting three strategic pillars: visibility, medical training, and coordination of the care system.

The first pillar seeks to raise awareness of the disease, promoting campaigns so that both the population and professionals recognize the early signs: enlargement of limbs, changes in voice, persistent tiredness or excessive sweating.

The second focuses on medical training, with the purpose of having general practitioners and specialists—cardiologists, pulmonologists, rheumatologists, and endocrinologists—include acromegaly among their differential diagnoses, especially in cases of hypertension or sleep apnea without apparent cause.

The third pillar, the articulation of the care system, proposes the creation of a national patient registry, the definition of clear diagnostic and treatment pathways, and the guarantee of equitable access to specialized services.

“The challenge of acromegaly goes beyond the doctor-patient relationship. It’s a structural challenge for the healthcare system,” warns Dr. Tovar. According to the specialist, it’s necessary to strengthen care pathways, ensure access to hormonal tests such as IGF-1 and GH, and have high-resolution imaging—such as pituitary MRI—available to confirm diagnoses.

Today, many patients must be referred to other cities or wait long periods to access these tests, which delays treatment and worsens the prognosis. Added to this is the need to ensure comprehensive monitoring of associated comorbidities, from cardiovascular health to bone and metabolic well-being.

For ACE, the commemoration of World Acromegaly Day is not limited to a symbolic date, but represents an opportunity to promote public policies, strengthen medical education and consolidate alliances between patients, health professionals and health authorities.

Environment and Health Journalist