Hypercortisolism in Obesity-Associated Hypertension

  • Amy G. Varughese
  • Oksana Nimkevych
  • Gabriel I. Uwaifo
Hypertension and Obesity (E Reisin, Section Editor)

DOI: 10.1007/s11906-014-0443-y

Cite this article as:
Varughese, A.G., Nimkevych, O. & Uwaifo, G.I. Curr Hypertens Rep (2014) 16: 443. doi:10.1007/s11906-014-0443-y
Part of the following topical collections:
  1. Topical Collection on Hypertension and Obesity

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.

Keywords

Obesity hypertension Hypercortisolism Subclinical Cushing’s syndrome Cortisol Glucocorticoids Hydrocortisone Dexamethasone Cortisone Aldosterone Elevated blood pressure Cortisol-associated hypertension Glucocorticoid-induced hypertension Pseudo Cushing’s syndrome Exogenous Cushing’s syndrome Glucocorticoid excess Dysmetabolic syndrome Insulin resistance Mineralocorticoid activation Adiposity Visceral fat excess 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Amy G. Varughese
    • 1
  • Oksana Nimkevych
    • 2
  • Gabriel I. Uwaifo
    • 1
  1. 1.Section of Endocrinology, Diabetes and Metabolism, Department of MedicineLouisiana State University Health Sciences Center (LSUHSC)New OrleansUSA
  2. 2.Section of Nephrology, Department of MedicineLouisiana State University Health Sciences Center (LSUHSC)New OrleansUSA

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