title: Cardiovascular disease in Cushing's syndrome: heart versus vasculature.
abstract: Cushing's syndrome (CS) causes metabolic abnormalities that determine an increased cardiovascular risk not only during the active phase of the disease but also for a long time after cure. Cardiovascular complications, such as premature atherosclerosis, coronary artery disease, heart failure, and stroke, in patients with CS cause a mortality rate higher than that observed in a normal population. The increased cardiovascular risk is mainly due to metabolic complications, such as metabolic syndrome, but also to vascular and cardiac alterations such as atherosclerosis and cardiac structural and functional changes. In the clinical management of patients with CS the focus should be on identifying the global cardiovascular risk and the aim should be to control not only hypertension but also other correlated risk factors, such as obesity, glucose intolerance, insulin resistance, dyslipidemia, endothelial dysfunction and the prothrombotic state. Considering that remission from hypercortisolism is often difficult to achieve and that the cardiovascular risk can persist even during disease remission, care and control of all cardiovascular risk factors should be one of the primary goals during the follow-up of these patients.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: De Leo
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.forename: Renata S
authors.initials: RS
authors.lastname: Auriemma
authors.forename: Alessia
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vitale
authors.forename: Chiara
authors.initials: C
authors.lastname: Simeoli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: De Martino
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D003480:Cushing Syndrome / Q000150:complications* / Q000503:physiopathology; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D012306:Risk