IGF1 and metabolic syndrome: The approach to hypertensive heart disease in patients with acromegaly is based on the tight control of hypertension through the use of antihypertensive drugs, reductions in GH and IGF-1 levels through surgery or pharmacological treatment, and the comprehensive management of associated cardiovascular comorbidities, such as diabetes mellitus, dyslipidemia, and sleep apnea [9,13,34,111,120,125].