Diurnal blood pressure variation in pheochromocytoma, primary aldosteronism and Cushing's syndrome.
We examined circadian blood pressure (BP) variation (expressed as a relative night-time BP decline) in subjects with primary aldosteronism (78 patients), pheochromocytoma (n=45) and Cushing's syndrome (n=18). Subjects with aldosterone-producing adenoma (n=21) and pheochromocytoma (n=27) were also investigated after the tumour removal. In all, 65 patients with essential hypertension served as a control group. The night-time BP decline was significantly attenuated in all three forms of endocrine hypertension compared to the control group (primary aldosteronism P<0.0001, pheochromocytoma P<0.0001 for systolic and diastolic BP and Cushing's syndrome P<0.0001/<0.001 vs essential hypertension). In the case of pheochromocytoma, the absence of the night-time BP decrease was more prominent compared to the primary aldosteronism group (P=0.003/0.001) and for the diastolic BP also in comparison with the Cushing's syndrome group (P=0.03). Tumour removal led in both groups to the restoration of the previously altered circadian rhythm (aldosterone-producing adenoma: P=0.0005/0.0009; pheochromocytoma: P=0.001/0.0007). Our study demonstrates a blunted circadian BP variation in all forms of adrenal hypertension in comparison with essential hypertension. This reduction of the night-time BP decrease was more prominent in pheochromocytoma than in primary aldosteronism or Cushing's syndrome.
Zelinka
T
T
3rd Department of Medicine, First Faculty of Medicine, Charles University, General Faculty Hospital, Prague, Czech Republic. tzeli@lf1.cuni.cz
Strauch
B
B
Pecen
L
L
Widimský
J
J
D000310:Adrenal Gland Neoplasms / Q000503:physiopathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000096:biosynthesis; D001794:Blood Pressure; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002940:Circadian Rhythm; D003480:Cushing Syndrome / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000503:physiopathology* / Q000601:surgery; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000503:physiopathology* / Q000601:surgery
D000450:Aldosterone