Alternations of Blood Pressure Following Surgical or Drug Therapy for Prolactinomas

Simple Summary Prolactinoma is the most common subtype and composes about 40-66% of all pituitary neuroendocrine tumors (PitNETs). Studies suggested that some other subtypes of PitNETs, such as Acromegaly and Cushing disease, could result in hypertension. However, this relationship remains unclear in prolactinoma. Our study revealed that in situ rat and xenograft nude-mice prolactinoma induced a significant BP increase, which was attenuated by cabergoline (CAB) treatment. In clinic, surgery decreased BP in prolactinoma patients both with or without hypertension. This BP-lowering effect was significantly associated with several variables, including age, sex, disease duration, tumor size, invasion, resistance to dopamine agonists (DAs), recurrence, and preoperative PRL levels.Abstract Several subtypes of pituitary neuroendocrine tumors (PitNETs), such as acromegaly and Cushing's disease, can result in hypertension. However, whether prolactinoma is associated with this complication remains unknown. Moreover, the effect of treatment with surgery or drugs on blood pressure (BP) is unknown. Herein, a retrospective study reviewed 162 patients with prolactinoma who underwent transsphenoidal surgery between January 2005 and December 2022. BP measurements were performed 1 day before and 5 days after surgery. Accordingly, patients' medical characteristics were recorded. In addition, in situ rat and xenograft nude-mice prolactinoma models have been used to mimic prolactinoma. In vivo BP and serum prolactin (PRL) levels were measured after cabergoline (CAB) administration in both rats and mice. Our data suggest that surgery can effectively decrease BP in prolactinoma patients with or without hypertension. The BP-lowering effect was significantly associated with several variables, including age, sex, disease duration, tumor size, invasion, dopamine agonists (DAs)-resistance, recurrence, and preoperative PRL levels. Moreover, in situ and xenograft prolactinomas induced BP elevation, which was alleviated by CAB treatment without and with a statistical difference in rats and mice, respectively. Thus, surgery or CAB can decrease BP in prolactinoma, indicating that pre- and postoperative BP management becomes essential.