Acromegaly is associated with a significantly increased mortality rate—historically 2 to 3 times higher than the general population—primarily due to cardiovascular, respiratory, and neoplastic complications. The chronic elevation of Growth Hormone (GH) and IGF-1 affects nearly every organ system. In the cardiovascular system, patients often develop "acromegalic cardiomyopathy," characterized by biventricular concentric hypertrophy and diastolic dysfunction. If untreated, this can progress to systolic heart failure.

Respiratory complications are also prevalent, with up to 70% of patients suffering from obstructive sleep apnea (OSA) due to macroglossia and soft tissue hypertrophy of the upper airways. Furthermore, there is a documented increase in the risk of colorectal polyps and potentially colorectal cancer, necessitating regular colonoscopy screenings starting at the time of diagnosis. Data regarding the standardized mortality ratios (SMR) and the impact of biochemical control on life expectancy can be found in the Acromegaly Market longitudinal studies. Modern therapeutic interventions that normalize IGF-1 levels have been shown to return the mortality risk to near-normal levels, emphasizing the importance of early aggressive treatment.