Secondly, pathological cardiovascular changes develop due to the increased secretion of growth hormone: In this group of patients, the occurrence of elevated systolic blood pressure, diastolic dysfunction with left ventricular hypertrophy, systolic dysfunction, the development of myocardial fibrosis, and an increased arterial stiffness as measured by the cardio-ankle vascular index (CAVI) can be observed. Here, GH1 is linked to left ventricular hypertrophy.