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[Secondary forms of hypertension. 5. Hypertension caused by Cushing syndrome and Conn's disease]

H S Füessl1

  • 1Ltd. Arzt Innere Abt., Bezirkskrankenhaus Haar, Ringstr. 33a, D-85540 Haar. HFuessl@compuserve.com

MMW Fortschritte Der Medizin
|March 30, 2002
PubMed

Insights

Conn syndrome (primary aldosteronism) and Cushing syndrome are key diagnoses for hypertension. Early magnetic resonance angiography aids Conn syndrome diagnosis, while clinical signs guide Cushing syndrome investigation, simplifying secondary hypertension management.

Area of Science:

  • Endocrinology
  • Cardiology
  • Medical Diagnostics

Background:

  • Hypertension investigation often involves differentiating between Conn syndrome (primary aldosteronism) and Cushing syndrome.
  • Primary aldosteronism affects less than 0.5% of hypertensive patients.
  • Cushing syndrome, a cause of hypertension in approximately 70% of patients, presents with characteristic cutaneous changes.

Purpose of the Study:

  • To outline diagnostic and management strategies for Conn syndrome and Cushing syndrome in hypertensive patients.
  • To emphasize the utility of magnetic resonance angiography in the early work-up of primary aldosteronism.
  • To highlight clinical indicators for suspecting Cushing syndrome.

Main Methods:

  • Initial diagnostic work-up for hypertension includes laboratory investigations.
  • Magnetic resonance angiography is recommended early for adrenal representation in suspected primary aldosteronism.
  • Clinical and biochemical confirmation precedes imaging for Cushing syndrome.

Main Results:

  • Magnetic resonance angiography provides excellent adrenal visualization, potentially reducing the need for extensive diagnostic tests.
  • Minimally invasive surgery and new pharmacotherapies have improved treatment outcomes for secondary hypertension caused by Conn syndrome.
  • Typical cutaneous changes are reliable indicators for clinical suspicion of Cushing syndrome.

Conclusions:

  • Early integration of magnetic resonance angiography can streamline the diagnosis of primary aldosteronism.
  • Recognizing clinical signs is crucial for timely diagnosis of Cushing syndrome.
  • Advances in surgical techniques and drug development have simplified the management of these secondary forms of hypertension.

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