title: Hypercortisolism in obesity-associated hypertension.
abstract: Obesity is prevalent worldwide and associated with co-morbidities that result in increased cardiovascular risk. Hypertension is the most prevalent obesity comorbidity associated with increased cardiovascular risk. Obesity hypertension is a distinct subtype of essential hypertension. While endogenous Cushing's syndrome is an uncommon cause of both obesity and hypertension, the recent recognition of other hypercortisolemic states has raised the profile of hypercortisolism as an important contributor in obesity hypertension. The high prevalence of exogenous, iatrogenic, pseudo, and subclinical Cushing's syndromes makes hypercortisolism an important diagnostic consideration in the evaluation and management of patients with obesity hypertension who are resistant to conventional management. Available data suggest that the renin-angiotensin-aldosterone system modulating antihypertensives have the best efficacy in hypercortisolism-mediated obesity hypertension. Strategies aimed at reducing cortisol production and action also have utility. This review provides a comprehensive overview of the epidemiology, etiopathogenesis and management options available for glucocorticoid-mediated obesity hypertension.
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Louisiana State University Health Sciences Center (LSUHSC), 1542 Tulane Avenue, New Orleans, LA, 70112, USA, avarug@lsuhsc.edu.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Varughese
authors.forename: Oksana
authors.initials: O
authors.lastname: Nimkevych
authors.forename: Gabriel I
authors.initials: GI
authors.lastname: Uwaifo
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003480:Cushing Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005938:Glucocorticoids / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006973:Hypertension / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D009765:Obesity / Q000150:complications* / Q000378:metabolism
chemical_list: D000959:Antihypertensive Agents; D005938:Glucocorticoids; D006854:Hydrocortisone