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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
.
Diseases
Validation
Diseases presenting
"also subclinical hypercortisolism"
symptom
adrenal incidentaloma
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