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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension: MOMENTUM

Jorge Plutzky1, Pam R Taub2, Deepak L Bhatt3

  • 1Brigham and Women's Hospital, Boston, Massachusetts, USA.

JACC. Advances
|February 17, 2026
PubMed
Summary

The MOMENTUM study investigates endogenous hypercortisolism in adults with resistant hypertension (rHTN). This research aims to determine the prevalence of this condition in a significant patient population.

Keywords:
cortisoldexamethasone suppression testendogenous hypercortisolismprevalenceresistant hypertension

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Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Hypertension is a major risk factor for cardiovascular disease and mortality.
  • Resistant hypertension (rHTN) affects up to 18% of hypertensive adults, increasing adverse outcomes.
  • Endogenous hypercortisolism is a potential cause of rHTN via multiple mechanisms.

Purpose of the Study:

  • The MOMENTUM study is the first large, observational, multicenter trial in the U.S. to assess the prevalence of endogenous hypercortisolism in adults with rHTN.
  • To investigate the link between endogenous hypercortisolism and resistant hypertension.
  • To provide new insights into the condition in patients with resistant hypertension.

Main Methods:

  • Enrollment of approximately 1,000 adult participants (≥18 years) with resistant hypertension (rHTN).
  • rHTN defined by American Heart Association criteria: SBP ≥130 mm Hg despite ≥3 antihypertensive medications (incl. diuretic) at max tolerated doses, or ≥4 medications regardless of SBP.
  • Endogenous hypercortisolism diagnosed by cortisol >1.8 μg/dL on 1-mg overnight dexamethasone suppression test (DST) with adequate dexamethasone levels (≥140 ng/dL).

Main Results:

  • Primary endpoint is the prevalence of endogenous hypercortisolism in the study population.
  • Data collection ongoing; results to be published upon study completion.
  • Anticipated to reveal significant prevalence data.

Conclusions:

  • The MOMENTUM study will offer novel insights into endogenous hypercortisolism within the resistant hypertension patient cohort.
  • Findings are expected to inform clinical practice and future research directions.
  • Understanding this link is crucial for managing complex hypertension cases.