Cardiovascular risk in Cushing's syndrome

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Metabolic Disorders

Background:

• Chronic cortisol hypersecretion in Cushing's syndrome leads to metabolic syndrome, including obesity, hypertension, insulin resistance, and dyslipidemia.
• These metabolic abnormalities significantly increase cardiovascular risk during active disease and persist long after achieving remission.

Purpose of the Study:

• To emphasize the critical need for comprehensive cardiovascular risk assessment in managing patients with Cushing's syndrome.
• To recommend specific diagnostic tools for early detection and management of associated metabolic and cardiovascular complications.

Main Methods:

• Review of clinical manifestations and long-term sequelae of Cushing's syndrome.
• Analysis of cardiovascular risk factors associated with hypercortisolism.
• Recommendation for extended screening protocols including oral glucose tolerance tests (OGTT) and vascular imaging.

Main Results:

• Metabolic syndrome and elevated cardiovascular risk are inherent to Cushing's syndrome, persisting post-remission.
• Effective management requires diligent control of all cardiovascular risk factors throughout patient follow-up.
• Early and regular screening can identify and mitigate diabetes mellitus and vascular complications.

Conclusions:

• Clinical management of Cushing's syndrome necessitates a proactive approach to identifying and controlling global cardiovascular risk.
• Implementing OGTT, echocardiography, and epiaortic vessel ultrasonography at diagnosis and during follow-up is recommended.
• This strategy aims to reduce the long-term cardiovascular burden in patients with Cushing's syndrome.