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Cardiovascular consequences of cortisol excess
Judith A Whitworth1, Paula M Williamson, George Mangos
1John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia. director@jcsmr.anu.edu.au
Insights
Cushing
Area of Science:
- Endocrinology and Cardiovascular Medicine
Background:
- Cushing's syndrome results from cortisol oversecretion, leading to significant cardiovascular disease.
- Cardiovascular complications persist even after treatment, posing a major health risk.
Purpose of the Study:
- To analyze the link between cortisol excess and cardiovascular risk factors.
- To explore mechanisms of hypertension in Cushing's syndrome.
Main Methods:
- Review of existing literature on cortisol, blood pressure, and related parameters.
- Analysis of studies correlating cortisol levels with cardiovascular risk factors.
- Examination of short-term cortisol administration effects in healthy men.
Main Results:
- Cortisol excess is associated with hypertension, obesity, and metabolic disturbances.
- Tissue-level cortisol influences cardiovascular risk factors.
- Short-term cortisol increases blood pressure in healthy individuals.
Conclusions:
- Cortisol excess significantly contributes to cardiovascular morbidity and mortality.
- Understanding cortisol's role is crucial for managing cardiovascular risks in Cushing's syndrome.
Abstract:
Cushing's syndrome is a consequence of primary or, more commonly, secondary oversecretion of cortisol. Cardiovascular disease is the major cause of morbidity and mortality in Cushing's syndrome, and excess risk remains even in effectively treated patients. The cardiovascular consequences of cortisol excess are protean and include, inter alia, elevation of blood pressure, truncal obesity, hyperinsulinemia, hyperglycemia, insulin resistance, and dyslipidemia. This review analyses the relationship of cortisol excess, both locally and at tissue level, to these cardiovascular risk factors, and to putative mechanisms for hypertension. Previous studies have examined correlations between cortisol, blood pressure, and other parameters in the general population and in Cushing's syndrome. This review also details changes induced by short-term cortisol administration in normotensive healthy men.
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