Influence of adrenal subclinical hypercortisolism on hypertension in patients with adrenal incidentaloma.

[adrenal incidentaloma]

The purpose of our study was to clarify whether subtle cortisol-producing tumors , such as not only subclinical Cushing 's syndrome (SubCS ) but also subclinical hypercortisolism (SH ), influence the prevalence of hypertension , since numerous basic research studies have noted that glucocorticoid excess influences blood pressure .80 patients with adrenocortical adenomas (39 women and 41 men ; mean age 62 .1 years ) were enrolled . SubCS was diagnosed using a diagnostic criteria , and SH was diagnosed as the presence of a serum cortisol level greater than 50 nmol /L following 1 -mg dexamethasone suppression test (DST ).SubCS , SH , or non-functioning adrenocortical adenoma (NF ) was diagnosed in 14 , 13 , or 53 patients , respectively . The prevalence of hypertension differed significantly among the diagnoses (SubCS , 78 .6 %; SH , 84 .6 %; NF , 39 .6 %; P =0 .002 ), whereas no differences in other clinical characteristics such as age , sex , or waist girth were observed . The patients with SH had an 11 .7 -fold increased risk (95 % confidence interval : 1 .9 -72 .7 , P =0 .009 ) and those with SubCS had a 9 .5 -fold increased risk (95 % confidence interval : 1 .9 -48 .3 , P =0 .007 ) for hypertension compared to those with NF using a multivariate analysis .We demonstrated that subtle cortisol-producing tumors , such as SH as well as SubCS , were an independent risk factor for hypertension . The cut-off value of the 1 -mg DST would be appropriate to predict the development of hypertension .

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adrenal incidentaloma

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