Hypercortisolism and Other Secondary Causes of Hypertension

In this episode, ‘Hypercortisolism and Other Secondary Causes of Hypertension,’ the panelists explore how cardiologists should think about hypercortisolism in the context of other secondary causes of hypertension, particularly primary aldosteronism. Expert cardiology faculty discuss the evolving understanding of hypercortisolism as a potentially common and underrecognized contributor to resistant hypertension and consider how recent evidence may influence future screening practices.

The panel examines the similarities between hypercortisolism and primary aldosteronism, highlighting how both conditions may be more prevalent than previously appreciated yet remain substantially underdiagnosed in clinical practice. They discuss findings from the MOMENTUM study and reflect on the observation that hypercortisolism may be identified as frequently as, or even more frequently than, other secondary causes of hypertension in certain patient populations.

Throughout the conversation, the panel of experts considers the implications of these findings for cardiovascular care and discusses whether screening approaches should evolve to include evaluation for cortisol excess alongside other established causes of secondary hypertension. They also explore the potential cardiovascular and metabolic consequences of untreated hypercortisolism and review emerging evidence suggesting that cortisol excess may contribute to resistant hypertension, insulin resistance, and increased cardiovascular risk.

The faculty emphasize the important role cardiologists can play in improving recognition of hypercortisolism and discuss how greater awareness may help identify patients who could benefit from targeted diagnostic evaluation and treatment. As the evidence base continues to expand, the discussion highlights the potential for hypercortisolism to become a more prominent consideration in the assessment of resistant hypertension.

The next episode in this series, ‘Hypercortisolism Screening in Cardiology Practice,’ features the panelists discussing the role of cardiologists in identifying patients at risk for hypercortisolism and initiating appropriate screening evaluations. They review practical testing approaches and highlight how early recognition may help uncover an important contributor to resistant hypertension and cardiometabolic disease.