Cardiovascular risk in Cushing's syndrome.
Chronic cortisol hypersecretion causes central obesity, hypertension, insulin resistance, dyslipidemia, protrombotic state, manifestations which form a metabolic syndrome in all patients with Cushing's syndrome. These associated abnormalities determine an increased cardiovascular risk not only during the active phase of the disease but also long after the "biomedical remission". Clinical management of these patients should be particularly careful in identifying global cardiovascular risk. Considering that remission from hypercortisolism is often difficult to achieve care and control of all cardiovascular risk factors should be one of the primary goals during the follow up of these patients. Extending the indications of the recent consensus on Cushing's syndrome, we suggest to carry out an OGTT to avoid underestimation of diabetes mellitus, an echocardiography and Doppler ultrasonography of the epiaortic vessels in all patients at diagnosis and during follow-up.
Arnaldi
Giorgio
G
Division of Endocrinology, Polytechnic University of the Marche Region, Ancona, Italy.
Mancini
Tatiana
T
Polenta
Barbara
B
Boscaro
Marco
M
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003480:Cushing Syndrome / Q000150:complications* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D018608:Ultrasonography, Doppler