Diagnosis and management of hypertension in patients with Cushing's syndrome: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension
Francesco Fallo, Guido Di Dalmazi, Felix Beuschlein, Nienke R. Biermasz, Frédéric Castinetti, Атанаска Еленкова, Martin Faßnacht, Andrea M. Isidori, Darko Kaštelan, Márta Korbonits, John Newell‐Price, Gianfranco Parati, Stephan Petersenn, Rosario Pivonello, Óskar Ragnarsson, Antoine Tabarin, Marily Theodoropoulou, Stylianos Tsagarakis, Elena Valassi, Przemysław Witek, Martín Reincke
Abstract
Endogenous/exogenous Cushing's syndrome is characterized by a cluster of systemic manifestations of hypercortisolism, which cause increased cardiovascular risk. Its biological basis is glucocorticoid excess, acting on various pathogenic processes inducing cardiovascular damage. Hypertension is a common feature in Cushing's syndrome and may persist after normalizing hormone excess and discontinuing steroid therapy. In endogenous Cushing's syndrome, the earlier the diagnosis the sooner management can be employed to offset the deleterious effects of excess cortisol. Such management includes combined treatments directed against the underlying cause and tailored antihypertensive drugs aimed at controlling the consequences of glucocorticoid excess. Experts on endocrine hypertension and members of the Working Group on Endocrine Hypertension of the European Society of Hypertension (ESH) prepared this Consensus document, which summarizes the current knowledge in epidemiology, genetics, diagnosis, and treatment of hypertension in Cushing's syndrome.