Cardiovascular consequences of cortisol excess.
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.
Whitworth
Judith A
JA
John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia. director@jcsmr.anu.edu.au
Williamson
Paula M
PM
Mangos
George
G
Kelly
John J
JJ
D001794:Blood Pressure; D002302:Cardiac Output; D002318:Cardiovascular Diseases / Q000209:etiology; D003480:Cushing Syndrome / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects* / Q000097:blood; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology; D006949:Hyperlipidemias / Q000097:blood / Q000209:etiology; D006973:Hypertension / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000097:blood / Q000209:etiology; D010953:Plasma Volume; D012084:Renin-Angiotensin System; D012307:Risk Factors; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014655:Vascular Resistance; D014664:Vasodilation; D014667:Vasopressins / Q000097:blood
D014667:Vasopressins; D006854:Hydrocortisone