Published August 8, 2022
0 views Journal article Open Access Open Access

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.

Creators

  • 1. Clinica Medica 3, Department of Medicine, University of Padova, Padova.
  • 2. University of Padua
  • 3. Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna.
  • 4. University of Bologna
  • 5. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • 6. Scientific Institute for Research, Hospitalization and Healthcare
  • 7. Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland.
  • 8. University of Zurich
  • 9. Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.
  • 10. Ludwig Maximilian University of Munich
  • 11. Leiden University Medical Center and European Reference Center for Rare Endocrine Conditions (Endo-ERN), Leiden, Netherlands.
  • 12. Leiden University
  • 13. Aix Marseille Université, Marseille Medical Genetics, INSERM.
  • 14. French Institute of Health and Medical Research
  • 15. Aix-Marseille University
  • 16. Assistance Publique Hopitaux de Marseille.
  • 17. Department of Endocrinology, La Conception Hospital, Marseille, France.
  • 18. Department of Endocrinology, University Specialized Hospital for Active Treatment in Endocrinology (USHATE) "Acad. Ivan Penchev", Medical University - Sofia, Sofia, Bulgaria.
  • 19. Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany.
  • 20. University of Würzburg
  • 21. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
  • 22. Sapienza University of Rome
  • 23. Department of Endocrinology, University Hospital Centre Zagreb, Zagreb University School of Medicine, Zagreb, Croatia.
  • 24. Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London.
  • 25. Queen Mary University of London
  • 26. Department of Oncology and Metabolism, Medical School, University of Sheffield.
  • 27. University of Sheffield
  • 28. Department of Endocrinology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • 29. Department of Cardiovascular, Neural and Metabolic Sciences Istituto Auxologico Italiano, IRCCS.
  • 30. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
  • 31. University of Milano-Bicocca
  • 32. ENDOC Center for Endocrine Tumors, Hamburg, Germany and University of Duisburg-Essen, Essen, Germany.
  • 33. University of Duisburg-Essen
  • 34. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli.
  • 35. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli.
  • 36. Unesco Chair for Health Education and Sustainable Development, "Federico II" University, Naples, Italy.
  • 37. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
  • 38. University of Gothenburg
  • 39. Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • 40. CHU de Bordeaux, Hôpital Haut Lévêque, University of Bordeaux, Bordeaux, France.
  • 41. University of Bordeaux
  • 42. Department of Endocrinology and Diabetes, Evangelismos Hospital, Athens, Greece.
  • 43. Endocrinology Unit, Hospital Germans Trias i Pujol, Badalona.
  • 44. Research Center for Pituitary Diseases (CIBERER Unit 747), Hospital Sant Pau, Barcelona, Spain.
  • 45. Department of Internal Medicine, Endocrinology and Diabetes, Mazovian Bródno Hospital, Medical University of Warsaw, Warsaw, Poland.

Description

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.
Enabled by The Lens

Open Access

Publisher Website Access full text