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[Cardiovascular diseases and lipid abnormalities in Cushing's syndrome]
Insights
Cushing
Area of Science:
- Endocrinology
- Oncology
- Cardiology
Context:
- Cushing's syndrome, characterized by excessive cortisol, affects numerous patients.
- Hypertension and dyslipidemia are common comorbidities.
- Adrenal tumors are a significant cause of Cushing's syndrome.
Purpose:
- To investigate the prevalence of hypertension and serum lipid abnormalities in patients with Cushing's syndrome.
- To assess the impact of treatments like Op'DDD and adrenalectomy on these metabolic disturbances.
Summary:
- 68% of 120 Cushing's syndrome patients had hypertension, especially with adrenal carcinoma.
- Op'DDD therapy or adrenalectomy normalized blood pressure in 85% of hypertensive cases.
- Combined hyperlipoproteinaemia affected 40% of 88 patients, normalizing after adrenalectomy but increasing with Op'DDD.
Impact:
- Treatment of Cushing's syndrome effectively manages associated hypertension.
- Adrenalectomy normalizes serum cholesterol, while Op'DDD requires careful monitoring due to lipid level increases.
- Understanding these comorbidities aids in comprehensive patient management and treatment planning.
Abstract:
The present study involved 143 patients with confirmed Cushing's syndrome, including 100 with Cushing's disease, 20 with adrenal adenoma and 23 with adrenal carcinoma. Out of 120 assessable patients 68% had arterial hypertension and the majority of these (78%) presented with adrenal carcinoma. Blood pressure returned to normal in 85% of hypertensive cases after Op'DDD therapy or adrenalectomy. Excessive cortisol production is probably the main cause of hypertension, but the precise pathophysiological mechanism is controverted. Serum lipids were studied in 88 patients, 40% of whom were found to have combined hyperlipoproteinaemia, this abnormality being particularly frequent in patients with malignant adrenal tumour. Serum cholesterol levels returned to normal after adrenalectomy. However, they were further increases during Op'DDD treatment (p less than 0.01) and only became normal after withdrawal of the drug. Cerebral vascular accidents were uncommon (6%) and might have been due to cobalt irradiation of the hypothalamus-pituitary region.