ArticleJournal of endocrinological investigation2025
Hypertension and kidney dysfunction despite long-term remission of Cushing's syndrome.
Article in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeHypertension is the most frequent co-morbidity in active Cushing's syndrome (CS) and regarded as a major cardio-vascular risk factor. It is unknown whether blood pressure and related parameters, such as kidney function, recover in the long-term following remission of CS.
methodsBlood pressure and related co-morbidities were analyzed in a cohort of 81 patients with CS (Cushing's disease: 52, ectopic CS: 8, adrenal CS: 21) from a single tertiary care center. Patients were longitudinally evaluated at baseline, at 7.1 years (6.3-7.4) and at 14 years (13.5-14.4) after biochemical remission. Data were compared to a control group matched for BMI, age and sex (n = 243) from the "Cooperative Health Research in the Region of Augsburg" study (KORA) in a 1:3 fashion.
resultsPatients with CS showed a higher median blood pressure and lower median glomerular filtration rate (GFR) compared to the matched controls, at baseline, 7 and 14 years after biochemical remission. Although the prevalence of hypertension and chronic kidney disease increased over time in the KORA cohort, patients treated for CS had a significantly higher prevalence of both comorbidities. Notably, the number of patients on antihypertensive medication declined in the Cushing's cohort, resulting in significantly higher rates of uncontrolled hypertension at follow-up.
conclusionThe prevalence of hypertension and impaired kidney function remained elevated in patients with CS years after biochemical remission, potentially contributing to an unfavorable long-term clinical outcome. This highlights the critical need for increased monitoring and treatment of co-morbidities in patients with CS following surgical remission.
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