Hypercortisolism Insights from MOMENTUM and CATALYST Trials

In this episode, ‘Hypercortisolism Insights from MOMENTUM and CATALYST Trials,’ the panelists explore the design, findings, and clinical implications of the MOMENTUM and CATALYST studies and discuss how emerging evidence is reshaping the understanding of hypercortisolism in resistant hypertension and difficult-to-control type 2 diabetes. Expert cardiology faculty review the rationale behind these landmark studies and examine the prevalence of hypercortisolism among patients with challenging cardiometabolic conditions.

The panel discusses how MOMENTUM evaluated patients with resistant hypertension and identified a substantial proportion with biochemical evidence of hypercortisolism, highlighting the potential role of cortisol excess as an underrecognized contributor to difficult-to-control blood pressure. They also review findings from CATALYST, which evaluated patients with inadequately controlled type 2 diabetes and demonstrated meaningful improvements in glycemic control and weight reduction following targeted treatment of hypercortisolism.

Throughout the discussion, the expert faculty explore the concept of precision medicine and consider how identifying underlying drivers of disease may help clinicians move beyond empiric treatment approaches. They discuss how targeted therapies may improve outcomes by addressing the root cause of cardiometabolic dysfunction rather than simply escalating medications to manage symptoms. The panel also examines recent subgroup analyses suggesting that hypercortisolism may impair responses to incretin-based therapies and highlights evidence showing an even greater prevalence of hypercortisolism among patients with both resistant hypertension and difficult-to-control diabetes. By reviewing emerging clinical data and therapeutic strategies, the panel provides valuable insights into the growing role of hypercortisolism screening and targeted intervention in modern cardiovascular and metabolic care.

The next episode in this series, ‘Management and Treatment Goals in Hypercortisolism,’ features the panelists discussing how cardiologists can support the management of patients with hypercortisolism-associated hypertension after diagnosis. They explore treatment goals, multidisciplinary care, and the importance of addressing the underlying cause of disease to improve cardiovascular outcomes.